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POPULAR   ESSAYS 


THE  CARE  OF  THE 


TEETH  AND  MOUTH 


By  victor  C.  BELL,  A.  B.,  D.  D.  S. 

Director  of  the  Special  Prosthetic  Department  of  the  New  York  College  of 
Dentistry.    Late  Dental  Surgeon  to  the  Oerman  Polyclinic. 


PUBLISHED   BY  THE   AUTHOR. 
1894. 


Copyrighted  ISOJ. 


BAKER,  JONES  &  CO.,  PRINTERS  AND  BINDERS. 
BUFFALO,  N.  Y. 


TABLE  OF  CONTENTS. 

PAGE. 

Chapter        I — Introductory,        .            .            .            .  .7 

Chapter      II — Cleanliness,     .....  13 

Chapter     III — Filling  the  Teeth,           .            .            .  .20 

Chapter     IV — Extraction  of  Diseased  Teeth,             .  .     29 

Chapter       V — Artificial  Teeth,        ....  37 

Chapter     VI — Advice  to  Mothers,           .            .            .  .44 

Chapter   VII — Children's  Teeth,        ....  56 

Chapter  VIII — Crown  and  Bridge  Work,     ...  64 

Chapter     IX — Fractured  Jaws,   .            .            .            .  .68 

Chapter       X — Cleft  Palate,  .....  74 

Chapter     XI — Hints  on  Home  Remedies,             .            .  .81 

Chapter    XII — Quackery,         ....  96 


PREFACE. 

This  work  is  the  outgrowth  of  the  observations  made 
in  daily  practice.  For  years  the  author  has  noted  and 
deplored  the  lack  of  information  upon  dental  subjects 
that  is  displayed  by  people  of  otherwise  great  general 
intelligence.  This  is  the  more  to  be  lamented,  because 
the  subject  is  a  vital  one,  and  the  consequences  of  igno- 
rance must  be  felt  during  the  whole  life.  He  candidly 
believes  that  were  the  information  contained  in  this 
little  book  generally  diffused,  and  its  teachings  well 
followed,  not  only  would  very  much  of  pain  and  suf- 
fering be  prevented,  but  the  general  term  of  human 
life  would  be  perceptibly  lengthened. 

This  book  has,  therefore,  been  prepared  in  the  hope 
that  it  may  in  some  way  be  used  to  spread  a  knowledge 
of  the  importance  of  the  dental  organs  among  the 
people,  especially  the  young,  through  the  medium  of 
the  schools.      It  has  not  been  written  especially  for 


VI  PREFACE. 

dentists,  and  hence  simplicity  of  language  has  been 
cultivated,  and  technical  terms  have  been  avoided. 
But  at  the  same  time  the  hope  is  indulged  that 
professional  men  may  find  it  useful  for  the  purposes 
indicated,  and  it  is  therefore  dedicated  to  dental  prac- 
titioners and  their  patients. 

The  author  desires  to  acknowledge  the  great  obliga- 
tions under  which  he  rests  to  Dr.  "William  Carr,  and 
Professors  W.  C.  Barrett,  Frank  Abbott  and  J.  B.  Littig, 
for  valuable  suggestions  and  assistance. 

New  York,  Jan.  1,  1894. 


CARE  OF  THE  TEETH  AND  MOUTH. 


CHAPTEE  I. 

INTRODUCTORY. 


"  Doctor,  does  not  the  cleaning  of  the  teeth  by  dental 

instruments  ruin  them  ?  " 

"  In  filling  the  teeth  are  not  their  nerves  killed,  and 

their  vitality  thus  destroyed  ? " 

"  Can  aching  teeth  be  made  serviceable  ? " 

"  Is  not  the  gas  that  is  administered  for  extraction 

very  dangerous  in  its  action  ? " 

"  Are  not  false  teeth  taken  from  the  dead  ?  " 

"Is  not  food  tasteless  to  the  wearer  of  artificial 

teeth  ? " 

Questions  such  as  these  are  constantly   asked   the 
practicing  dentist. 

"  Miss  A.,  why  do  you  not  attend  to  your  teeth  ? " 
"  O  !    I  am  so  afraid  of  the  dentist  and  his  torturing 
instruments." 


»  CABE  OF  THE  TEETH  AND  MOUTH. 

"Mr,  B,,  why  do  you  not  have  your  teeth  put  in 
order  ? " 

"  Well,  I'm  too  busy,  and  just  now  they  do  not  bother 
me." 

Thus  it  is  that  Miss  A.  and  Mr.  B.  neglect  these  es- 
sential organs,  until  decay  and  disease  have  so  far  pro- 
gressed that  they  are  beyond  the  skill  of  the  dentist, 
and  irretrievably  lost. 

How  often  do  patients  present  themselves  to  the  den- 
tist with  teeth  so  filthy  that  one  recoils  with  disgust 
and  aversion  at  beholding  them.  Add  to  this  a  number 
of  ulcerated  roots,  or  decayed  teeth  with  large  cavities 
in  which  decomposing  food  remains  for  weeks  and 
months,  and  you  will  no  longer  wonder  why  sometimes 
the  breath  of  an  individual  is  so  oflPensive  and  foul  that 
his  presence  is  unbearable.  Wherever  there  is  de- 
composition of  organic  matter,  there  innumerable  col- 
onies of  microbes,  the  germs  of  disease,  are  generated. 
Through  a  mouth  thus  infected,  can  any  individual  pass 
his  food  and  yet  wonder  why  he  suffers  from  indi- 
gestion ?  An  eminent  writer,  speaking  upon  this  sub- 
ject, says : 

"  The  stomach  may  be  compared  to  a  stove ;  the  food 
to  the  fuel  consumed  by  the  stove,  and  life  to  the  heat 
given  off  by  the  glowing  coals.  The  stomach  is  an  ex- 
cellent stove,  and  will  burn  much  bad  fuel.  But  have 
a  care  lest  it  rebel,  and  the  fire  be  extinguished."     To 


INTRODUCTORY     CHAPTER.  9 

maintain  a  vigorous  and  sustained  vital  glow,  the  food 
taken  into  the  stomach  must  be  thoroughly  ground  by 
the  teeth,  and  mixed  with  the  saliva,  and  it  must  not 
be  mingled  with  any  deleterious  accumulations  in  the 
mouth. 

Good  health  demands  thorough  digestion  ;  thorough 
digestion  demands  thorough  mastication,  and  thorough 
mastication  demands  sound  and  healthy  teeth.  Ulcer- 
ated roots  and  decayed  teeth,  an  inflamed  mouth  and 
vitiated  saliva,  are  poorly  fitted  to  supply  the  stomach 
with  food  that  can  be  properly  digested  and  assimilated. 

Abscesses  with  agonizing  pains,  necrosed  jaws  and 
probable  disfigurement  of  the  face,  with  tumors  and 
foreign  growths  of  varying  character,  frequentl}'^  result 
from  a  neglected  mouth. 

Many  other  diseases,  as  of  the  eye,  ear,  and  the  cavi- 
ties of  the  head,  often  the  most  difficult  to  diagnose, 
may  be  traced  directly  to  an  unhealthy  condition  of 
the  teeth.  But  a  short  time  ago,  I  was  visited  by  a 
young  lady  whose  eyes  were  so  badly  affected  that  she 
could  only  see  with  great  difficulty.  Medical  treatment 
had  failed  to  relieve  her.  Having  trouble  with  her 
teeth,  she  found  it  necessary  to  consult  the  dentist,  and 
with  the  curing  of  her  dental  troubles  her  ej^esight  was 
restored. 

I  have  seen  the  most  robust  patients  shattered  in 
health  by  dental  troubles.     "Who  is  not  familiar  with 


10  CARE  OF  THE  TEETH  AND  MOUTH. 

the  acute  suffering  with  which  the  development  of  an 
abscess,  or  swelhng  on  the  gums  or  face,  is  accom- 
panied ?  The  pain  is  not  only  agonizing,  but  the  gen- 
eral health  is  affected.  Surgeons  and  dentists  are  daily 
called  upon  to  perform  operations  for  the  removal  of 
necrosed  portions  of  bones,  and  tumors  of  the  most 
formidable  character,  and  sometimes  even  for  the 
removal  of  the  entire  jaw.  There  is  not  a  disease  to 
which  the  human  body  is  liable  that  is  not  aggravated 
by  an  unhealthy  condition  of  the  teeth. 

It  is  marvelous  to  observe  how  men  will  spend  money 
in  the  most  extravagant  manner  for  outward  show,  or 
will  wear  away  the  best  part  of  their  lives  in  the  ac- 
cumulation of  wealth,  and  yet  never  give  a  thought  or 
a  penny  to  the  preservation  of  health.  But  there  will 
come  a  day  when  disease  shall  have  so  wasted  their 
system  as  to  place  its  recovery  beyond  all  medical  skill, 
and  then  they  will  realize  the  full  consequences  of  their 
neglect. 

It  is  in  the  comprehension  of  these  facts  that  I  have 
written  this  book.  In  it  I  shall  discuss  the  following 
topics : 

1.  Cleanliness. 

2.  Filling  the  teeth. 

3.  Extraction  of  diseased  teeth. 

4.  Artificial  teeth. 


INTBODUCTORY  CHAPTEK.  11 

5.  Advice  to  mothers. 

6.  Children's  teeth. 

7.  Crown  and  bridge  work. 

8.  Fractured  jaws. 

9.  Cleft  palate. 

10.  Hints  on  home  remedies. 

1 1 .  Quacker}^ 

I  have  adopted  this  system  of  division  because  I 
think  it  not  only  the  most  logical,  but  that  which  is 
best  calculated  to  give  the  reader  a  knowledge  of  the 
dangers  incurred  by  neglect  of  the  teeth,  and  of  the 
best  remedial  measures  to  be  employed  when  suffering 
from  such  a  course. 

Before  concluding  this  chapter,  I  may  say  that  the 
lack  of  knowledge  displayed  by  the  popular  mind  on 
these  subjects,  has  aroused  in  me  the  desire  to  place 
before  my  readers,  in  a  concise  form,  such  information 
as  will  be  of  service  to  them  in  all  dental  emergencies, 
and  which,  if  carefully  followed,  will  add  to  their  health 
and  strength,  and  to  their  consequent  happiness. 

In  preparing  these  pages,  I  have  had  primarily  before 
me  the  fact  that  just  such  a  book  is  needed,  to  throw 
some  light  upon  a  common  subject  that  is  not  suffi- 
ciently considered  in  the  ordinary  courses  of  school 
instruction. 

I  have  endeavored  to  avoid  the  use  of  technical  terms, 


12 


CAEE  OF  THE  TEETH  AND  MOUTH. 


and  to  study  simplicity  in  the  language  employed,  as  it 
is  my  sole  intention  to  interest  the  popular  mind  with 
matters  which  are  familiar  to  the  medical  and  dental 
professions. 


CHAPTER  II. 


CLEANLINESS. 


The  importance  of  keeping  the  mouth  free  from  rem- 
nants of  food  and  masses  of  tartar  cannot  be  too  strongly- 
impressed  upon  the  reader.  It  is  no  exaggeration  to 
say  that  ninety-five  per  cent,  of  all  dental  troubles  are  the 
direct  outcome  of  uncleanliness.  When  particles  of  food 
are  allowed  to  accumulate  upon  and  between  the  teeth, 
fermentation,  which  will  be  subsequently  explained,  takes 
place,  and  decay  is  the  result.  Or  putrefaction  may  en- 
sue, and  the  mouth  become  a  very  center  of  disease  and 
infection.  If  the  mouth  could  be  kept  perfectly  clean 
and  pure,  teeth  would  never  decay,  but  as  this  is  impos- 
sible, it  only  remains  for  us  to  clean  the  teeth  thoroughly 
after  each  meal,  that  the  particles  of  food  may  be  as 
perfectly  removed  as  is  practicable. 

Tartar. — This  is  a  deposit  of  animal  and  mineral 
matter,  precipitated  from  the  fluids  of  the  mouth  upon 
the  teeth.  Sometimes  it  accumulates  in  such  large 
quantities  as  completely  to  incrust  them.  It  imparts  to 
the  teeth  a  greenish,  yellowish,  darkish,  and  sometimes 
a  white  color.     Its  effects  upon  the  teeth  are  : 


14  CARE  OF  THE  TEETH  AND  MOUTH. 

1.  It  makes  the  gums  spongy  and  sloughy,  and 
causes  them  to  bleed  at  the  slightest  irritation, 

2.  It  produces  suppuration  of  the  gums,  and  pus 
accumulates,  sometimes  in  considerable  quantities,  mak- 
ing the  mouth  exceedingly  unwholesome. 

3.  It  forces  the  gums  from  the  teeth,  and  working 
its  way  between  them  produces  such  an  absorption  of 
the  bony  sockets  as  to  cause  the  latter  either  to  fall  out 
of  their  own  account,  or  to  be  taken  out  at  the  least 
exhibition  of  any  force. 

4.  It  vitiates  the  saliva,  and  as  this  fluid  is  essential 
to  digestion,  the  digestive  apparatus  is  deranged  and 
the  entire  system  is  disturbed. 

5.  It  imparts  a  disagreeable  odor  to  the  breath. 
This  is  one  of  the  most  disgusting  features  of  a  filthy 
mouth,  and  makes  the  sufferer  obnoxious  to  all. 

If,  then,  one  would  preserve  his  teeth  and  avoid  these 
diseases,  he  should  keep  them  free  from  decaying  food 
and  tartar,  by  the  most  unremitting  attention.  This 
cannot  be  done  by  merely  polishing  the  exposed  surfaces. 

"When  once  allowed  to  become  encrusted  with  tartar, 
no  one  can  thoroughly  clean  his  own  teeth,  because  he 
can  neither  see  where  the  masses  are,  nor  can  he  use  the 
proper  instruments  for  their  removal.  The  work  can 
only  be  well  done  by  the  dentist.  Everyone,  then, 
should  visit  his  dentist  at  least  twice  each  year,  for 
cleaning  and  examination  of  his  teeth. 


CLEANLINESS.  15 

We  often  hear  the  question  asked,  if  cleaning  the 
teeth  with  instruments  does  not  injure  the  enamel,  or  if 
they  are  not  so  irritated  as  to  cause  disease,  and  per- 
haps instances  are  cited  in  which  the  teeth  of  a  friend 
have,  in  their  imagination,  been  led  to  decay  because  of 
the  work  done  upon  them  by  some  dentist  in  cleaning. 

It  is  undoubtedly  true,  that  when  teeth  are  cleaned 
cavities  of  decay  that  were  masked  by  tartar  are  un- 
covered, but  in  such  instances  the  cause  existed  before 
professional  aid  was  sought. 

Neither  the  medicines  nor  the  instruments  employed 
by  a  good  dentist  will,  in  any  case,  injure  the  teeth.  In 
the  first  place,  no  respectable  practitioner  would  employ 
any  remedies  that  could  be  harmful.  In  the  next  place, 
the  instruments  are  of  the  finest  make,  while  the  enamel 
is  too  hard  to  be  abraded  by  them.  The  pain  com- 
plained of  is  caused  by  the  removal  of  the  tartar  that 
has  been  allowed  to  accumulate  beneath  the  gums, 
and  which  had  forced  them  from  the  necks  of 
the  teeth,  leaving  that  portion  bare  and  exposed.  A 
few  daj^s  will  accustom  them  to  the  changed  condition, 
when  the  irritation  will  subside. 

The  decay  of  which  the  patient  complains  was  not 
caused,  but  revealed,  by  the  cleaning.  Sooner  or  later 
it  would  have  manifested  itself,  as  the  coatings  of 
filth  and  tartar  had  been  silently  doing  their  work  of 
destruction,   and   the  cleaning,  far  from  inducing  the 


16  CAKE  OF  THE  TEETH  AND  MOUTH. 

decay,  simply  exposed  its  existence,  and  warned  the 
patient  to  check  its  further  progress. 

After  the  teeth  have  been  thoroughly  cleaned  by  the 
dentist,  to  preserve  them  in  this  condition  the  patient 
should  wash  them  with  lukewarm  water,  and  polish 
frequently  with  a  powder  or  mouth-wash,  using  a  soft 
brush. 

Lukewarm  water  should  be  used,  because  it  cleanses 
much  more  effectively  than  either  that  which  is  very 
cold  or  very  warm,  and  because,  even  if  the  cold  and 
warm  water  could  clean  as  perfectly,  they  should  still 
be  avoided,  as  they  act  injuriously  upon  the  teeth. 

Every  layman  has  no  doubt  observed  for  himself  the 
physical  law  that  heat  expands,  while  cold  contracts 
bodies.  No  one  would  think  of  removing  a  glass 
tumbler  from  a  basin  of  very  cold  to  very  hot  water, 
or  vice  versa,  because  he  knows  that  the  rapid  expansion 
or  contraction  which  would  follow  might  break  the 
glass.  It  is  in  a  similar  manner  that  the  enamel  of  the 
teeth  may  be  cracked,  when  very  cold  or  very  warm 
substances  succeed  each  other  in  the  mouth. 

In  choosing  a  brush,  select  a  soft  rather  than  a  harsh 
one,  as  the  latter  irritates  and  abrades  the  gums.  Brush 
from  the  gums  toward  the  summits  of  the  teeth,  or 
longitudinally,  and  not  transversely.  By  brushing  across 
them,  particles  of  food  are  forced  between  the  teeth, 
where  they  may  become  centers  of  decay.     After  using 


CLEANLINESS. 


17 


the  brush,  wash  it  carefully,  that  all  de- 
composable matter  which  may  have  been 
caught  by  the  bristles  may  be  removed. 

In  the  absence  of  a  brush,  a  silk  thread 
is  an  excellent  substitute.  By  forcing  it 
between  the  teeth,  all  matter  which  may 
have  lodged  there  is  removed.  Indeed, 
floss  silk,  prepared  for  this  purpose,  is  an 
excellent  thing  with  which  to  supplement 
the  tooth  brush. 

Powders  and  mouth-washes,  when  free 
from  acid,  should  be  employed  in  clean- 
ing the  teeth.  Great  care  and  judgment 
should,  however,  be  exercised  in  their  se- 
lection, and  only  those  recommended  by 
some  reputable  dentist  should  be  used. 

The  fact  that  a  certain  powder  or  mouth- 
wash is  extensively  advertised,  does  not 
add  to  its  value.  As  a  rule,  avoid  such 
preparations,  for  they  may  contain  acids^ 
which,  while  they  clean  rapidly,  are  very 
destructive. 

The  teetii  ai'c  chiefly  composed  of  mineral  salts. 
Acids  have  a  great  affinity  for  these,  and  when  brought 
in  contact  with  the  teeth  corrode  or  dissolve  them,  and 
in  this  way  make  their  surfaces  rough,  and  bring  about 
their  destruction. 


A  toothbrush  of 
proper  form. 


18  CAKE  OF  THE  TEETH  AND  MOUTH. 

The  following  powder,  containing  nothing  deleteri- 
ous, will  excellently  answer  the  purpose  for  which  it 
is  intended : 

Bicarbonate  of  Soda,  -        -        half  ounce. 

Precipitated  Chalk,         _        _        .    two  ounces. 
Pulverized  Orris  Eoot,        -        -        one  ounce. 
Pulverized  Castile  Soap,  -        -    one  ounce. 

Flavor  with  Peppermint  or  Wintergreen. 

It  is  sufficient  to  employ  a  powder  every  other  day. 
Its  too  frequent  use  may  abrade  the  teeth,  and  wear 
them  away.  In  the  intervals,  the  brush  and  water  will 
suffice. 

After  the  teeth  have  been  carefully  brushed,  the 
mouth  should  be  daily  rinsed  with  a  mouth-wash. 

Lime  water  is  excellent  for  this  purpose,  and  should 
be  freely  used.  Its  peculiar  virtue  consists  in  the  fact 
that  it  is  an  alkali — that  is,  it  neutralizes  the  effects 
of  acids.  Food  may  contain  acids,  or  the  saliva  may  be 
acid,  a  condition  that  frequently  exists  when  the 
patient  is  in  a  debilitated  condition. 

Those  who  object  to  lime  water  because  of  its  un- 
pleasant taste,  may  remove  this  objectionable  feature 
by  using  with  it  a  few  drops  of  oil  of  rose,  or  cologne. 

The  following  mouth-wash  is  a  most  excellent  one, 
as  it  is  antiseptic,  sweet  to  the  taste,  and  is  also  alkaline 
in  its  reaction : 


CLEANLINESS.  19 

Bicarbonate  of  Soda        -        -  half  ounce. 

Simple  Elixir      ....  two  ounces. 

Distilled  Water        ...  ten  ounces. 

Tinct.  Cochineal  -        -        -  q.  s. 

Einse  the  mouth  with  this  solution  twice  daily,  in  the 
morning  after  cleaning  the  teeth,  and  in  the  evening 
before  retiring. 

If  the  directions  here  given  are  carefully  followed, 
the  result  will  be  a  clean  and  sweet  mouth,  a  pure 
breath,  hard,  firm  gums  and  sound  teeth. 


CHAPTEK  III. 


FILLING   THE  TEETH. 


Judging  from  the  questions  constantly  asked  the 
dentist,  it  is  no  exaggeration  to  say  that  very  few  peo- 
ple have  a  clear  conception  of  the  causes  which  lead  to 
decay  of  the  teeth. 

Experiments  and  observation  have  shown  that  these 
are  numerous.  Chief  among  them  is  the  fermentation 
of  particles  of  food  lodged  between  the  teeth,  or  in 
their  pits  or  depressions,  during  mastication.  When, 
through  carelessness  or  indifference,  these  deposits  are 
not  removed,  under  the  influence  of  the  warmth,  mois- 
ture and  the  microbes  present,  fermentation,  or  chem- 
ical change  takes  place  and  an  acid  is  generated,  and 
this  dissolves  the  enamel  and  dentine,  leaving  a  cavity, 
which  constantly  grows  larger  and  deeper. 

The  dentine  is  of  a  tubular  structure,  and  into  these 
tubules  the  microbes  which  constantly  exist  in  the 
mouth  penetrate,  where  they  continue  their  destructive 
effect  until  the  tooth  is  completely  destroyed. 

Microbes  are  minute  vegetable  organisms,  some  of 
the  many  species  of  which  are  so  small  that  they  are 


FILLING    THE   TEETH.  21 

only  visible  under  the  highest  powers  of  the  microscope. 
They  are  the  cause  of  a  large  class  of  infectious  or 
contagious  diseases,  and  between  them  and  the  body 
there  is  a  constant  struggle. 

The  process  of  fermentation  is  of  itself  but  the 
growth  and  multiplication  of  these  minute  organisms, 
and  in  this  process  of  their  life-history  the}^  produce  the 


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« 

Microbes,  micro-organisms  or  bacteria,  greatly  enlarged. 

acids  and  other  poisonous  material  which  make  them 
so  fatal  to  mankind.     Their  number  is  inconceivable. 

These  are  the  direct  causes  of  decay  of  the  teeth. 
But  there  also  exist  indirect,  or  contributing  causes,  and 
these  may  be  anything  which  will  lower  the  general 
tone  of  the  system,  and  make  it  less  able  to  resist  the 
action  of  deleterious  agents. 

Among  these  secondary  causes  producing  decay,  may 
be  mentioned  any  protracted  sickness,  the  lack  of  out- 
door exercise,  excessive  study,  anxiety  or  worry,  which 


22  CAKE  OF  THE  TEETH  AND  MOUTH. 

undermine  and  weaken  the  system.     When  the  body  is 
ill,  no  one  organ  can  be  said  to  be  perfectly  sound. 

The  teeth  may  be  crowded  or  depressed,  or  there 
may  be  fissures  which  offer  a  ready  means  for  lodge- 
ment of  food.  The  waUs  of  the  teeth  may  not  be 
dense,  and  their  power  of  resisting  decay  may  be  very 
weak,  or  the  food  may  not  contain  the  necessary  ele- 


1^    \         t 


*«5  1%  f 


}  -.  i  I 


'a 

Other  forms  of  Microbes,  greatly  enlarged. 

ments  for  nourishing  the  teeth,  and  hence  the  work  of 
repairing  the  wear  and  tear  of  daily  use  may  be  but 
poorly  accomplished. 

Again,  there  may  be  a  hereditary  tendency  to  decay. 
That  our  ancestors  suffered  from  any  special  ailment 
does  not  necessarily  demonstrate  that  it  will  be  repro- 
duced in  us,  but  it  is  probable  that  the  same  debilitating 
conditions  will  be  inherited.  Their  consequences  can, 
however,  be  avoided  b}^  proper  and  unremitting  care. 
These  causes  are  constantly  at  work,  producing  decay 
of    the  teeth  and  forming  minute  cavities,   through 


FILLING    THE  TEETH  23 

which  the  decay  rapidly  progresses  until  the  living 
matter  of  the  tooth  is  reached.  Unless  this  is  checked, 
the  tooth  will  be  totally  wrecked ;  even  if  it  be  not 
wholly  destroyed,  it  will  be  so  badly  decayed  that  it 
will  threaten  the  welfare  of  the  entire  dentition,  and 
therefore  it  ma}^  become  necessary  to  extract  it. 

Many,  fearing  that  the  filling  of  a  tooth  will  be  pain- 
ful, refuse  to  have  this  done.  But  when  the  proper 
manipulation  is  employed,  the  operation  is  accompanied 
by  very  little  of  acute  pain,  and  if  the  decay  is  of  re- 
cent formation,  by  none  at  all.  Every  consideration, 
then,  whether  the  ultimate  welfare  of  the  tooth  is  con- 
cerned or  the  desire  be  to  avoid  suffering  and  discom- 
fort, prompts  the  patient  to  early  attention  to  his  teeth, 
before  decay  shall  have  proceeded  so  far  as  to  cause 
toothache. 

The  teeth  are  composed  of  four  principal  parts, — 
Enamel,  Dentine,  Cementum  and  Pulp. 

Enamel. — This  constitutes  the  cap,  outer  covering,  or 
occluding  surface  of  the  tooth.  It  is  the  hardest  tissue 
in  the  animal  body.  Its  great  density  admirably  adapts 
it  to  the  purposes  of  mastication  of  hard  substances. 
The  enamel  is  easily  distinguishable  from  the  dentine 
with  the  naked  eye,  by  its  clear,  lustrous,  and  somewhat 
translucent  appearance. 

Dentine. — The  dentine  forms  the  principal  constitu- 
ent of  the  tooth.     It  is  situated  under  the  enamel,  and 


24  CARE  OF  THE  TEETH  AND  MOUTH. 

is  permeated  by  a  great  number  of  minute  canals, 
which  connect  with  the  pulp  chamber.  It  is  a  hard, 
elastic  substance,  with  a  yellowish  tinge,  and  is  slightly 
translucent. 

Cementum. — This  forms  a  thin  covering  for  the  sur- 
face of  the  fang,  or  root  of  the  tooth,  and  extends  from 
its  neck  to  the  apex. 

Pulp. — The  pulp  is^a  soft  tissue,  occupying  the  pulp 
chamber,  which  is  an  elongated  canal,  wide  at  the 
crown,  and  narrow  at  the  root.  It  runs  longitudinally 
through  the  center  of  the  dentine.  The  pulp  contains 
the  nerves  and  blood  vessels  of  the  tooth.  It  is  the 
vital  part,  and  sends  forth  minute  fibers  of  living  mat- 
ter through  the  microscopic  canals  of  the  dentine,  to 
nourish  and  endow  the  tooth  with  sensation. 

As  soon  as  the  enamel  is  decayed  through,  the  sensi- 
tive dentine  rapidly  disappears  under  the  action  of  the 
acids  produced  by  fermentation,  and  the  pulp  soon  be- 
comes exposed. 

Frequently  the  decay  of  the  sixteenth  part  of  an  inch 
is  sufficient  to  lay  bare  the  pulp.  This  is  extremely 
sensitive,  and  the  contact  of  any  foreign  matter  causes 
the  most  exquisite  sufi'ering.  The  least  change  of  tem- 
perature, or  the  exertion  of  any  undue  pressure  upon 
it,  will  so  irritate  its  nerve  filaments  as  to  produce  se- 
vere toothache,  and  affect  the  entire  nervous  system  of 
the  head. 


FILLING    THE  TEETH.  25 

Before  the  pulp  has  become  exposed,  the  operation  of 
fllhng  the  teeth  is  comparatively  painless.  The  filling 
lasts,  and  the  tooth  remains  strong,  because  the  vital 
portions  of  the  pulp  have  not  been  affected. 

It  is  easy  to  discover  when  the  dentine  alone  is  ex- 
posed. This  may  be  sensitive  to  the  touch,  to  cold  and 
to  heat,  but  the  pain  is  dull,  and  passes  away  when  the 
irritating  agent  is  removed.  When,  however,  the  pulp 
is  exposed,  the  pain  is  acute,  constant,  severe  and  ago- 
nizing. Thus  the  degree  and  character  of  the  pain  will 
indicate  the  amount  of  the  decay.  Should  the  tooth 
be  neglected  when  the  pulp  has  become  exposed,  the 
latter  becomes  inflamed,  and  the  work  of  filling  the 
teeth  is  very  painful,  and  perhaps  impossible,  and  if  the 
neglect  be  persisted  in,  the  pulp  dies. 

Thus  at  the  outset  the  dentist  is  confronted  with 
three  classes  of  diseased  teeth  —  those  in  which  the 
dentine  alone  is  affected,  those  in  which  the  pulp  has 
been  but  recently  exposed,  and  those  in  which,  because 
of  prolonged  exposure,  the  pulp  is  either  dead  or  dying. 
Of  the  first  class  I  have  already  spoken.  In  a  tooth  of 
the  second  class,  the  pulp  can  be  cured  by  the  applica- 
tion of  soothing  medicines,  which  may  remove  the  irri- 
tation and  subdue  the  inflammation,  and  enable  it  to 
bear  a  filling.  If,  after  being  thus  treated,  the  tooth 
be  filled,  a  covering  of  secondary  dentine  may  be 
formed  by  nature  underneath  the  filling,  for  the  better 


26  CAKE  OF  THE  TEETH  AND  MOUTH. 

protection  of  the  pulp,  and  soon  the  tooth  may  become 
as  sound  as  ever. 

Concerning  the  third  class  of  decayed  teeth,  there 
are  three  kinds.  Those  in  which  the  pulp  has  recently 
died,  those  in  which  there  is  more  or  less  of  infection 
and  inflammation,  and  those  with  a  fistulous  opening, 
with  a  more  or  less  constant  discharge  of  pus.  The 
first  can  be  cured  with  comparative  ease.  The  second 
may  be  relieved  if  judicious  means  are  employed,  while 
the  third  may  require  a  considerable  time,  and  the  exer- 
cise of  much  patience  and  skill  on  the  part  of  the  den- 
tist. The  pulp  chamber  and  canals  must  be  thoroughly 
cleaned  and  disinfected,  and  this  work  is  sometimes 
performed  with  great  difficulty,  as  the  canals  are  often 
crooked  and  difficult  of  access. 

Should  the  dentist  fill  such  a  tooth,  leaving  within 
it  particles  of  infected  matter  in  the  pulp  canal,  they 
may  putrefy  and  generate  gases,  which,  having  no  es- 
cape except  through  the  opening  at  the  apex  of  the 
tooth,  press  against  the  surrounding  tissues,  and  produce 
abscesses  and  swellings,  with  their  accompanying  pains. 
After  the  whole  territory  has  been  thoroughly  disinfect- 
ed, the  canals  must  be  effectually  filled.  It  is  sometimes 
advisable  to  insert  a  temporary  filling  to  last  for  sev- 
eral weeks,  and  only  after  this  experimental  stopping 
has  been  sufficiently  tried,  and  no  unfavorable  symptoms 
have  supervened,  should  a  permanent  filling  be  substi- 


FILLING   THE  TEETH.  27 

tuted  for  the  temporary  one.  If,  however,  the  tooth 
becomes  sore,  it  is  an  indication  that  inflammation  is 
asfain  active,  and  that  unless  it  be  reduced  an  abscess 
ma}'  follow.  The  filling  must  then  be  removed,  and 
the  tedious  work  of  disinfection  resumed. 

It  is  apparent,  then,  that  to  postpone  the  work  of 
filling  a  decayed  tooth  only  increases  the  danger  and 


Different  forms  of  microbes,  very  much  enlarged. 

suffering,  while  the  result,  when  accomplished,  is  much 
less  satisfactory. 

There  are  some  dentists  who  promptly  apply  an  ar- 
senical paste  to  sensitive  cavities,  whether  the  pulp  be 
exposed  or  not,  and  patients  have  been  led  to  approve 
this,  thinking  thereby  to  avoid  pain  during  the  filling. 
But  it  is  very  bad  practice,  and  the  more  reputable 
portion  of  American  dentists  condemn  it  earnestly,  and 
for  some  of  the  follow ina'  reasons  : 


28  CAEE  OF  THE  TEETH  AND  MOUTH. 

First,  because  when  devitalized,  there  is  always  the 
liability  to  putrefaction  and  the  formation  of  an  abscess. 

Second,  because  it  is  much  easier  to  fill  a  live  tooth 
than  a  dead  one. 

Third,  because  a  dead  tooth  is  liable  to  many  diseases, 
and  is  not  as  permanent  or  as  useful  as  a  live  one. 

To  destroy  the  pulp  quickly,  arsenic  is  employed. 
Unless  this  be  carefully  and  skillfully  used,  there  may 
be  intense  pain.  The  cavity  must  be  carefully  and  deli- 
cately cleaned  of  all  foreign  material,  the  irritability  of 
the  pulp  must  be  allayed,  and  then  the  proper  devitaliz- 
ing agent  must  be  so  inserted  that  no  pressure  will  be 
exerted.  When  this  is  skillfully  done  no  pain  will  ensue. 
But  it  is  much  better  if  the  pulp  can  be  saved  alive,  and 
the  honest  dentist  will  therefore  put  forth  every  exer- 
tion to  do  this. 

A  few  words  as  to  the  materials  to  be  used  in  filling 
the  teeth.  Gold  and  tin  possess  all  the  requisite  quali- 
ties for  beautiful  and  lasting  fillings.  Silver  is  only 
used  in  the  form  of  an  amalgam,  with  mercur3^  Gutta 
percha  and  cement  form  excellent  temporary  fillings 
for  teeth  so  decayed  that  they  cannot  stand  the  strain 
incident  to  the  filling  with  gold  or  tin  foils.  The  choice 
of  materials  should,  however,  be  left  to  the  dentist,  as 
he  best  knows  the  peculiar  conditions,  and  what  they 
demand. 


CHAPTER  IV. 

EXTRACTION  OF  DISEASED  TEETH. 

Extraction  is  an  ultimate  remedy,  and  should  be 
resorted  to  in  extreme  cases  only.  If  people  would 
give  to  their  teeth  the  attention  that  is  their  due, 
there  would  be  no  occasion  for  the  forceps,  except  in 
very  rare  and  exceptional  instances.  It  is  because  of 
ignorance,  or  inexcusable  carelessness,  or  the  uncon- 
querable dread  of  dental  operations,  that  the  necessity 
for  the  removal  of  teeth  arises.  Timely  care  might 
preserve  even  those  which  are  naturally  weak  and  bad. 

But,  through  neglect,  cases  arise  which  imperatively 
demand  extraction.  Let  us  consider  some  of  the  conse- 
quences of  a  refusal  to  have  this  done. 

The  most  common  of  these  are  abscesses. 

Abscesses,  or  gumboils,  are  collections  of  pus,  or 
putrid  matter,  due  to  infection  and  inliammation  of  the 
tissues  surrounding  the  roots  of  diseased  teeth.  These 
may  produce  many  dangerous  results,  amoug  which  are 
those  that  follow : 

Locked  Jaw.  — Sometimes  a  severe  abscess  is  caused 
by  diseased  molars  or  wisdom  teeth  of  the  lower  jaw. 


30  CAKE  OF  THE  TEETH  AND  MOUTH. 

The  nerves  become  so  irritated  that  they  are  finally 
paralyzed,  and  the  muscles  remain  in  a  contracted  con- 
dition. They  cannot  perform  their  office,  and  the 
sufferer  is  unable  to  open  or  close  his  mouth.  When 
this  happens,  the  patient  is  said  to  suffer  from  locked 
jaw.  It  should  be  understood  that  by  this  term  is  not 
meant  tetanus,  or  spasmodic  contractions. 

Netjealgia. — Intense  neuralgia  of  the  eye,  the  ear, 
or  the  entire  side  of  the  face,  is  frequently  produced  by 
the  pressure  of  an  abscess  and  the  irritation  due  to  a 
diseased  tooth.  All  the  nerves  which  supply  the  eye, 
the  ear,  the  face  and  the  teeth,  are  intimately  connected 
through  their  terminal  filaments,  and  any  special  irrita- 
tion of  one  may  be  communicated  to  and  affect  any  of 
the  others. 

The  oculist  and  aurist  recognize  that  the  eye  and 
ear  may  be  affected  by  diseased  teeth,  and  so,  very 
often,  before  proceeding  with  their  work,  insist  that 
the  patient  have  his  teeth  put  in  good  condition. 

Neckosis.  —  Death  of  the  bone  frequently  results 
from  an  abscess.  When  pus  is  allowed  to  accumulate 
in  large  quantities,  it  may  burrow  between  the  bone 
and  the  periosteum,  or  membrane  which  envelops  the 
bone,  and  which  gives  to  it  nutrition  and  vitality.  This 
membrane  being  severed  from  the  bone,  the  latter  dies 
from  lack  of  nutrition,  and  from  the  violent  inflamma- 
tion caused  by  the  abscess. 


EXTK ACTION    OF    DISEASED    TEETH.  31 

Eye,  Ear  and  Nose. — These  organs  are  very  often 
affected  by  diseased  teeth.  Over  the  molars,  in  each 
side  of  the  upper  jaw  bone,  there  exists  a  cavity,  the 
roof  of  which  is  formed  by  the  floor  of  the  orbit,  its 
inner  boundary  being  the  wall  of  the  nose,  and  through 
which  there  is  an  opening  into  the  nostril.  The  floor 
of  this  cavity  is  formed  by  that  portion  of  the  jaw  bone 
which  holds  the  roots  of  the  molars,  and  into  which 
one  of  them  occasionally  penetrates.  The  walls  of  the 
cavity  are  thin,  and  are  lined  by  a  very  sensitive  mem- 
brane. Any  serious  disease  of  these  penetrating  mo- 
lars, such  as  inflammation  and  suppuration,  ma}'^  extend 
into  this  cavity.  Pus  may  accumulate  in  such  large 
quantities  that  it  will  ooze  out  through  the  opening  that 
communicates  with  the  nose. 

Thus  may  be  seen  why,  when  one  suffers  from  a  con- 
stant discharge  from  the  nose,  it  may  be  due  to  a  neg- 
lected tooth.  Again,  if  the  accumulation  of  pus  is  very 
large,  it  may  press  against  the  floor  of  the  eye-ball,  and 
either  displace  the  eye  or  cause  partial  or  complete 
blindness,  or  it  may  break  through  the  bone  and  dis- 
charge upon  the  face,  leaving  an  ugly  scar.  At  the 
very  least,  the  continued  discharge,  even  though  it  may 
not  find  its  way  to  the  surface,  makes  the  patient  a  con- 
stant source  of  offense,  both  to  himself  and  those  who 
surround  him. 
Cases  are  reported   in  which  tumors  caused  by  dis- 


32  CAEE  OF  THE  TEETH  AND  MOUTH. 

eased  teeth  have  developed  to  such  enormous  size  that 
they  plugged  up  the  nose,  dislodged  the  eye,  and  even 
broke  down  the  wall  of  the  cavity  and  penetrated  into 
the  brain. 

Again,  whenever  a  decayed  tooth  is  in  close  proxim- 
ity to  a  sound  one,  the  latter  will  ultimately  be  affect- 
ed, for  wherever  there  is 
decay,  there  we  find  acids 
and    microbes,    which    in 
their  action  are  very  de- 
structive to  the  teeth. 
Every    day   that    these 
ui^Z^TopeT^th.  teeth    are    permitted    to 

remain  in  the  mouth  but 
aggravates  the  condition,  and  renders  their  inevit- 
able fate,  extraction,  more  and  more  difficult.  This 
is  particularly  the  case  with  regard  to  the  molars, 
which,  as  a  rule,  have  several  roots,  all  connected 
by  the  crown.  When  decay  has  destroyed  the 
crown,  the  roots  become  separated,  and  must  be  ex- 
tracted singly.  Sometimes  the  patient  attributes 
this  difficulty  to  lack  of  skill  on  the  part  of  the 
dentist,  and  perhaps  even  institutes  legal  proceedings 
for  malpractice  against  men  of  acknowledged  skill. 
These  suits,  though  almost  invariably  unsuccess- 
ful, have  in  many  cases  blighted  the  reputation 
of   the   practitioner,   for  suspicion  easily  attaches  to 


EXTRACTION    OF    DISEASED    TEETH.  3'6 

professional  men,  and  clings  to  them  with  fatal 
tenacity. 

"We  may  thus  see  the  importance  of  an  early  extrac- 
tion of  such  badly  decayed  teeth.  But  many  people 
shrink  from  the  operation,  either  by  reason  of  their 
ignorance,  or  because  of  the  misrepresentations  of  their 
friends,  or  through  a  fear  of  the  pain.  Let  me  illustrate 
a  case  of  very  frequent  occurrence. 

"A"  is  suffering  from  an  abscess  developed  from  irri- 
tation produced  by  a  dead  tooth.  He  is  about  to  visit 
the  dentist  to  have  the  tooth  extracted,  when  some 
officious,  though  well-meaning  friend,  informs  him  that 
it  is  dangerous  to  extract  the  tooth  before  the  abscess 
has  broken,  and  "A"  will  suffer  many  days  and  nights 
of  intense  agony,  waiting  for  the  abscess  to  heal,  and 
after  this  has  taken  place  and  he  no  longer  suffers  tor- 
ture, he  undergoes  the  additional  pain  of  having  the 
tooth  extracted.  As  a  matter  of  fact,  there  is  no  dan- 
ger in  extracting  a  tooth  about  which  an  abscess  is  de- 
veloping. There  was  a  time  when  it  was  thought 
hazardous  to  do  so,  it  is  true,  but  this  theory  has  long 
since  been  exploded.  Moreover,  the  pain  of  extracting 
such  a  tooth  is  entirely  lost  in  the  far  greater  pain  suf- 
fered from  the  abscess,  for  when  one  suffers  from  pains 
of  varying  intensity,  the  sensation  of  the  lesser  pain  is, 
to  a  greater  or  less  extent,  lost  in  that  of  the  greater. 

There  are  many  who  fear  to  have  a  tooth  removed 


34  CAEB  OF  THE  TEETH  AND  MOUTH. 

because  of  the  accompanying  suffering.  In  reality, 
there  is  little  pain  in  the  extraction  of  a  tooth.  The 
sleeplessness,  anxiety,  and  lack  of  proper  food  which 
precede  the  extraction,  weaken  the  body,  and  hence  the 
nerves  are  very  susceptible  to  irritation.  The  pain  of 
extraction  principally  results  from  these  causes,  and  not 
from  the  extraction  itself.  Fortunately  for  the  sufferer, 
however,  by  the  use  of  nitrous  oxide  gas,  the  extraction 
of  teeth  may  be  made  absolutely  painless. 

This  gas  is  obtained  by  heating  a  substance  techni- 
cally called  ammonium-nitrate  in  a  retort.  This  salt  is 
composed  of  hydrogen,  nitrogen  and  oxygen.  The 
last  two  gases  are  the  chief  constituents  of  the  air  we 
breathe,  and  in  differing  proportions  compose  nitrous 
oxide  gas. 

Though  odorless  and  colorless,  the  gas  is  sweet  to  the 
taste ;  through  its  action  upon  the  nerves  there  is  an 
entire  loss  of  consciousness,  and  with  that  of  course  all 
sensation  and  volition.  This  lasts  but  a  few  moments. 
There  is  naturally  considerable  shrinking  from  it  on 
the  part  of  those  who  are  unacquainted  with  its  char- 
acter. But  statistics,  carefully  collected,  show  that  it  is 
by  far  the  safest  of  the  anaesthetics,  and  when  properly 
administered  that  there  is  less  risk  from  it  than  from 
the  operation  itself.  It  is  given  daily  by  many  who 
possess  no  special  medical  knowledge,  and  who  take  no 
precautions  as  to  examination  before  administering  it. 


EXTRACTION  OF  DISEASED  TEETH.  35 

Yet  rarely  has  any  harm  resulted,  even  though  patients 
were  suffering  from  diseases  which  are  of  themselves 
dangerous. 

I  may  add  that  in  many  cases  nitrous  oxide  has 
proven  a  remedial  agent,  and  where  other  remedies  have 
failed  it  has  afforded  relief.  It  may  even  be  adminis- 
tered to  women  in  the  later  stages  of  pregnancy.  The 
shock  experienced  by  the  nervous  system  from  extract- 
ing a  tooth  without  the  gas,  is  far  more  dangerous  and 
more  likely  to  produce  evil  results  than  would  the  same 
operation  be  with  it.  While  it  is  true  that  during  this 
period  women  should  not  have  their  teeth  extracted 
unless  it  becomes  absolutely  necessary,  it  is  equally  true 
that  expectant  mothers  should  not  be  permitted  to  suf- 
fer from  protracted  pain.  The  effect  of  that  upon  both 
the  mother  and  babe  may  prove  a  lasting  injury  to 
each,  during  all  the  years  of  their  subsequent  life. 

Let  the  patient  take  the  gas  on  an  empty  stomach, 
and  be  perfectly  calm ;  then  its  inhalation  will  be  safe, 
and  it  will  relieve  the  dreaded  extraction  of  all  its 
horrors. 

In  conclusion,  let  me  add  that  if  people  have  badly 
decayed  teeth  or  roots  that  do  not  ache,  they  should  at 
once  be  put  in  a  sanitary  condition.  If  this  cannot  be 
done,  they  should  be  extracted,  for  if  allowed  to  remain 
they  may  bring  in  their  train  any  one  of  a  long  hst  of 
diseases. 

4 


36 


OAEE  OF  THE  TEETH  AND  MOUTH. 


With  the  badly  decayed  teeth  removed,  and  the  re- 
maining ones  cleaned,  filled,  capped  or  crowned,  as  the 
case  may  demand,  the  mouth  will  be  in  a  thoroughly 
healthy  condition,  and  if  any  reasonable  degree  of  care 
be  bestowed  upon  it,  will  probably  remain  so  for  many 
years. 


CHAPTER  V. 


ARTIFICIAL    TEETH. 


Teeth  are  subservient  to  three  great  functions — 
beauty,  speech,  and  digestion. 

Beauty. — From  the  remotest  ages,  the  poet  and  the 
uovehst  have  found  in  the  teeth  a  fruitful  theme  for 
song,  Hov/  they  revel  in  painting  their  charms !  no 
face,  however  rich  in  beauty,  color,  or  regularity  of  its 
features,  is  a  finished  conception  with  an  incomplete 
denture.  Nay,  if  the  denture  be  imperfect  in  the  front 
of  the  mouth,  the  charms  of  the  face  but  heighten  the 
inharmony  into  repellent  incongruity. 

We  are  all  ambitious  to  please,  by  conforming  to  the 
laws  of  the  beautiful.  In  society,  one  who  understands 
the  laws  of  harmony  dehghts  the  eye  by  her  tasty 
attire.  Another,  though  more  richly  dressed,  having 
failed  to  harmonize  her  costume,  attracts  attention  only 
by  the  impression  of  absurdity. 

In  the  purchase  of  any  article  of  clothing,  we  all 
recognize  that  something  besides  the  mere  fit  or  adapta- 
tion must  be  observed.    However  excellent  the  material 


38  CAKE  OF  THE  TEETH  AND  MOUTH. 

or  the  workmanship,  a  certain  law  of  harmony  must  be 
observed,  or  the  wearer  will  appear  ludicrous. 

I  make  bat  a  mild  statement,  then,  when  I  say  that 
it  is  extremely  unpleasant  to  behold  a  pair  of  ripe, 
cherry  lips,  open  but  to  disclose  an  incomplete  denture. 
The  contrast  with  what  was  expected  becomes  very 
jarring. 

Speech. — Teeth  are  necessary,  not  only  to  beauty, 
but  to  speech.  When  any  of  them  are  missing,  the 
power  of  speech  is  more  or  less  impaired,  because  they 
are  necessary  to  the  proper  formation  of  articulate 
sounds,  and  unless  all  of  the  teeth  are  present  in  the  mouth, 
the  result  is  an  incomplete  and  discordant  utterance. 
There  is  a  certain  relation  between  the  physical  form 
and  the  voice,  from  which  we  infer  in  advance  the  char- 
acter of  the  tones  which  may  be  expected  from  any 
individual,  and  if  instead  of  the  expected  bass  a  falsetto 
greets  us,  the  result  is  very  unpleasant.  Speakers  and 
singers  recognize  this  fact  so  well,  that  the  instant  the 
denture  becomes  incomplete  they  have  it  repaired. 

Digestion.  —  The  most  important  function  of  the 
teeth  is  to  assist  in  digestion,  by  masticating  and  insali- 
vating the  food.  Mastication  is  the  process  of  reducing 
the  food  to  a  pasty  condition,  by  grinding  it  into  small 
particles  and  mixing  it  with  saliva. 

If  before  passing  the  food  into  the  stomach  this  work 
of  mastication  is  thoroughl}^  performed,  the  food  is 


ARTIFICIAL    TEETH.  39 

rendered  easily  susceptible  to  the  action  of  the  fluid 
secreted  b}^  the  stomach — the  gastric  juice.  This  reduces 
the  food  to  a  liquid  state,  and  so  prepares  it  for  absorp- 
tion into  the  system.  When,  however,  the  food  is 
swallowed  without  being  thoroughly  masticated — that 


An  Artificial  lower  Denture. 

is,  in  mass,  or  in  a  dry  condition — the  action  of  the 
gastric  juice  is  very  slow,  and  to  a  considerable  extent 
ineffective.  It  moreover  fails  to  yield  all  the  nourish- 
ing essence  of  which  it  is  possessed,  and  causes  in  addi- 
tion those  intense  agonies  of  indigestion,  which  a  cele- 
brated writer  once  so  forcibly  described  as  "  a  hundred 
rats  gnawing  in  the  stomach." 

Good  health  requires  good  digestion,  and  good  diges- 
tion requires  good  mastication;  but  so  long  as  any  of 
the  teeth  are  missing  this  is  impossible,  for  nature, 
economical   in  all   things,  teaches  that  unless  all  the 


4:0  CARE  OF  THE  TEETH  AND  MOUTH. 

teeth  were  necessary,  some  of  them  would  not  be  found 
in  the  mouth. 

As  the  functions  of  the  teeth  are  of  such  paramount 
importance,  it  is  necessary  that  they  be  kept  in  constant 
repair,  and  if  any  of  them  are  missing  they  should  be 
immediately  replaced.  The  modern  dentist  has  reduced 
this  art  to  a  science,  and  artistically  constructs  artificial 
dentures,  crowns  and  bridges. 

Artificial  Teeth  or  Dentures. — There  are  two  parts 
in  a  set  of  artificial  teeth.     The  plate  and  the  teeth. 

The  Plate.— This  is  a  thin  sheet  of  rubber  or  metal, 
corresponding  in  shape  to  the  hard  palate  or  roof  of  the 

mouth.  The  rubber  base  is  in 
most  common  use,  as  it  is 
cheap  and  serviceable.  Rub- 
ber is  the  coagulated  milky  juice 
of  certain  trees,  that  grow  in 
South     America     and     other 

An  Artificial  upper  Denture.  ,     .  .    «,  i 

warm  countries.  After  under- 
going many  chemical  changes,  this  is  manufactured 
into  rubber  of  various  grades.  Only  the  best  is  used 
by  the  reputable  dentist,  after  it  has  been  subjected 
to  many  delicate  manipulations  and  processes. 

Among  some  of  the  metals  used  in  the  manufacture 
of  dental  bases  are  gold,  silver,  platinum  and  aluminum. 
These  are  the  precious  metals,  and  only  such  are  fit  for 
use  in  dentistry. 


ARTIFICIAL   TEETH.  41 

Teeth. — The  teeth  are  attached  to  the  plate  so  as  to 
correspond  exactly  to  the  natural  denture,  in  size, 
shape  and  order  of  arrangement.  Thej"  are  manufac- 
tured from  porcelain,  which  is  a  compound  of  silex, 
feldspar  and  kaolin. 

Silex  is  a  v/hite  mineral,  found  in  sands,  rocks, 
crystals  and  flint. 

Feldspar  is  generall}^  found  as  an  ingredient  of  granite 
and  other  volcanic  rocks. 

Kaolin  is  a  fine  clay,  found  in  many  parts  of  the 
world. 

From  these  minerals,  together  with  the  use  of  color- 
ing matter,  artificial  teeth  are  manufactured. 

P'rom  various  fancies  or  prejudices,  none  of  which 
have  any  foundation  in  fact,  many  people  object  to  the 
use  of  any  artificial  appliance  in  the  mouth.  Some, 
because  they  are  ashamed  to  wear  artificial  teeth,  or 
because  they  are  under  the  impression  that  they  taint 
the  breath,  and  destroy  the  sense  of  taste.  Others, 
because  they  believe  that  artificial  teeth  are  taken  from 
the  dead,  or  that  an  artificial  denture  cannot  be  held 
securely  in  the  mouth. 

No  false  sentiment  should  be  allowed  to  interfere 
with  the  laws  of  health  or  proper  hygiene.  Beauty, 
speech  and  mastication  are  primary  considerations, 
and  no  mere  aff'ectation  has  the  right  to  negative  their 
demands. 


42  CAKE  OF  THE  TEETH  AND  MOUTH. 

Artificial  teeth  neither  destroy  the  sense  of  taste  nor 
contaminate  the  breath.  The  sense  of  taste  is  located 
in  the  tongue,  and  there  is  not  a  single  ingredient 
entering  into  the  composition  of  the  rubber  or  teeth 
which  can  infect  the  breath.  N'or  are  artificial  teeth 
ever  taken  from  the  dead.  Their  very  name  shows 
that  they  are  the  product  of  man's  handiwork;  they  are 
manufactured  from  the  pure  materials  that  I  have 
already  enumerated. 

To  those  who  fear  that  a  denture  cannot  be  held 
firmly  in  the  mouth,  let  me  say  that  their  apprehen- 
sions are  groundless.  To  secure  the  plate  in  the  mouth 
it  is  necessary  to  utilize  two  forces  of  nature — adhesion 
and  atmospheric  pressure. 

Adhesion. — Adhesion  is  that  force  by  virtue  of  which 
the  molecules  of  different  bodies  cling  together.  A 
remarkable  instance  of  this  is  found  when  we  press 
together  two  smooth  or  occluding  surfaces.  Adhesion 
is  so  strong  that  they  will  cling  together  with  great 
tenacity.  If  we  press  together  two  perfectly  level  sur- 
faces of  glass,  it  will  be  found  very  difficult  to  separate 
them. 

Atmospheric  Peessure. — The  air  presses  in  every 
direction  with  a  force  of  about  15  lbs.  to  the  square 
inch.  A  little  computation  demonstrates  that  the 
human  body,  for  instance,  is  subjected  to  a  constant 
pressure  of  from  20,000  to  30,000  pounds.     This  would 


ARTIFICIAL   TEETH.  43 

be  sufficient  to  crush  us  to  the  earth,  were  it  not  that 
the  air  presses  equally  in  all  directions.  Hence  the 
downward  pressure  is  counter-balanced  by  an  equal  up- 
ward pressure.  This  may  be  proven  by  an  actual 
experiment. 

Take  a  glass  jar,  the  mouth  of  which  is  accurately 
fitted  to  a  smooth  metal  surface,  and  by  means  of  an 
air  pump  exhaust  the  air  within  it.  ISTow  try  to  lift  the 
jar,  and  it  will  be  found  that  it  adheres  with  great 
tenacity.  There  is  no  air  within  to  counteract  the  down- 
ward pressure  of  that  without.  But  if  the  air  be  al- 
lowed to  re-enter  the  jar,  it  can  be  raised  as  easily  as  ever. 
Children  ])laying  with  the  familiar  leather  soakers, 
unconsciously  take  advantage  of  adhesion  and  atmos- 
pheric pressure.  When  the  soaker  is  pressed  down  upon 
the  stone,  the  air  is  forced  out,  and  they  are  enabled 
to  lift  the  stone,  whirl  it  in  the  air,  or  carry  it  about. 

Artificial  plates  are  constructed  upon  a  model  taken 
from  an  impression  of  the  mouth,  and  it  is  thus 
made  accurately  to  fit  the  hard  palate  and  gums. 
There  are  two  perfectly  occluding  surfaces,  the  palate 
and  the  plate.  When  these  are  brought  into  contact 
the  air  is  driven  from  between  them,  and  adhesion  and 
atmospheric  pressure  are  called  into  play.  Hence  the 
plate  is  held  in  the  mouth  by  the  action  of  natural 
forces,  and  the  patient  need  not  worry  himself  by  con- 
juring up  imaginary  difficulties. 


CHAPTER  yi. 


ADVICE   TO    MOTHERS. 


Weee  one  to  say  to  the  mother,  as  she  lovingly 
fondles  her  young,  "  ninety  per  cent  of  the  diseases 
from  which  your  child  will  suffer  in  after  life  are  directly 
traceable  to  your  treatment  of  it,"  would  she  not  deny 
the  assertion  with  unbounded  indignation  ?  And  yet, 
the  charge  is  true,  for  it  must  be  apparent  even  to  a 
superficial  observer,  that  women,  as  a  rule,  possess  such 
an  imperfect  knowledge  of  the  laws  of  hygiene  as  to 
be  but  poorly  equipped  for  a  thorough  training  of  their 
young. 

There  was  a  time  when  diseases  were  regarded  as  the 
manifestations  of  the  wrath  of  an  offended  Deity,  who 
could  only  be  appeased  by  oflPering  up  sacrifices  on  the 
altars  of  the  Gods,  and  as  men  thought  it  hopeless  to 
struggle  against  the  Deity,  they  paid  little,  if  any,  at- 
tention to  the  laws  of  hygiene.  Those  times,  however, 
have  passed.  Our  higher  culture  has  swept  away  these 
idle  superstitions,  and  has  revealed  to  us  the  universal 
reign  of  inexorable  laws.  This  should  teach  us  that 
health  is  the  reward  of  obedience  to  these  laws ;  disease, 


ADVICE  TO  MOTHERS. 


45 


the  penalty  of  their  infraction.  They  are  easily  ascer- 
tainable, and  readily  followed.  Indeed,  such  progress 
has  been  made  in  their  systemization  and  comprehen- 
sion, that  we  can  almost  choose  between  health  and 
disease,  bnt  to  secure  the  full  measure  of  advantage 
which  must  result  from  an  adherence  to  these  laws, 
their  study  should  not  be  postponed  to  mature  hfe.  It 
must  begin  in  early  infancy,  and  be  made  to  form  part 
of  the  home  and  school  training,  for  knowledge  and 
impressions  received  in  childhood  are  the  most  lasting, 
and  are  readily  developed  into  fixed  habits. 

The  training  of  the  child  during  this  early  period  of 
its  life  is  peculiarly  the  work  of  the  mother,  and  not  all 
the  study  and  thought  of  after  life  can  thoroughly  erad- 
icate the  ideas  and  habits  which  she  can  impress  upon 
its  young  mind.  To  perform  the  work  of  education 
efficiently,  the  mother  must  be  as  familiar  with  the  laws 
of  the  child's  physical  existence  as  she  is  with  the  laws 
of  its  moral  well  being. 

Yet,  while  we  realize  that  without  an  intimate  ac- 
quaintance with  the  principles  of  good  health  immunity 
from  disease  is  impossible,  we  have  made  no  united 
effort  to  instruct  our  women  so  that  they  can  perform 
this  duty.  Nay,  if  some  woman,  more  intelligent  and 
enterprising  than  the  rest  of  her  sex,  makes  a  thorough 
study  of  hygiene  and  of  kindred  topics,  she  too  often 
becomes  a  subject  for  ridicule  among  her  acquaintances. 


46  CAEE  OF  THE  TEETH  AND  MOUTH. 

They  seem  to  think,  as  did  women  of  yore,  that  the 
circle  of  woman's  attainments  is  bounded  by  the  hori- 
zon of  man's  pleasures,  and  that  if  she  has  acquired  a 
knowledge  of  dancing,  singing,  music,  courtly  manners, 
and  a  little  understanding  of  household  management, 
she  is  equipped  for  the  duties  of  life,  of  marriage,  and  of 
maternity.  To  dispel  this  delusion,  and  awaken  in  wo- 
men a  sincere  desire  to  familiarize  themselves  with  the 
laws  of  health,  which  is  the  object  of  my  present 
chapter,  is,  therefore,  of  the  utmost  importance.  The 
evils  which  result  from  disobedience  of  these  laws  are 
not  confined  to  women  alone,  but  are  transmitted  to 
their  offspring,  and  in  this  way  are  perpetuated.  Truly, 
"The  evil  which  men  do,  fives  after  them."  How 
forcibly  did  Henry  Ward  Beecher  realize  this,  when,  in 
answer  to  the  question  "When  should  a  child's  educa- 
tion begin,"  he  said,  "  With  its  grandfather."  It  is  my 
province,  however,  only  to  consider  those  hygienic  laws 
which  are  intimately  connected  with  the  welfare  of  the 
teeth.  A  discussion  of  the  remaining  principles  is  not 
the  office  of  the  dentist,  but  of  the  general  physician. 

For  the  sake  of  clearness  and  logical  arrangement,  I 
shall  divide  this  chapter  into  two  topics : 

First,  "  Hints  to  Women  in  General." 
Second,  "  Hints  to  Pregnant  Women." 


ADVICE  TO  MOTHERS. 


47 


Hints  to  Women  in  General. 


Lack  of  cleanliness  and  of  proper  dieting  are  undoubt- 
edly the  main  causes  which  contribute  to  the  destruction 
of  the  teeth.    As  the  subject  of  cleanliness  has  already 
been  discussed  at  length,  I  shall 
now    proceed    to   consider  the 
subject  of  proper  diet,  by  which 
I  mean  not  only  what  to  eat, 
but  also  how  to  eat. 

What  to  Eat.  —  This  is  a 
question  that  must  be  solved 
differently  for  different  indi- 
viduals. The  food  which  is 
proper  for  one  man  may  not 
agree  with  another.  The  stu- 
dent, or  the  brain  worker,  could 
not  long  subsist  on  that  re- 
quired by  the  laborer,  or  the 
out-door  toiler.  Time,  age  and 
occupation  must  all  be  consid- 
ered before  it  may  be  said  to 
any  man, "  Eat  this  or  that  kind 
of  food."  Yet,  in  spite  of  this  difficulty,  there  are 
certain  foods  of  which  it  may  be  said  that  they  are 
safe  to  all. 

The  human  body  is  composed  of  seventeen  elements, 


Upper  and  Lower  Permanent 
Teeth  in  Outline. 


48  CARE  OF  THE  TEETH  AND  MOUTEt. 

the  chief  of  which  are  hydrogen,  nitrogen,  carbon,  and 
the  salts  of  hme.  The  various  organs  of  the  body  are 
formed  by  varying  combinations  of  a  certain  number  of 
these  elements,  and  these  organs  sustain  and  nourish 
themselves  by  extracting  from  the  blood  a  sufficient 
quantity  of  the  elements  which  enter  into  their  forma- 
tion, so  that  if  the  food  is  deficient  in  any  one  element, 
some  one  organ  of  the  body  is  destined  to  suffer.  As 
no  foods,  except  milk  and  eggs,  contain  all  the  elements 
which  enter  into  the  structure  of  the  body,  it  is  appar- 
ent that  to  properly  nourish  all  our  organs,  recourse 
must  be  had  to  a  diversified  diet.  In  this  way  the 
abundance  of  a  certain  element  in  one  food  may  supply 
its  deficiency  in  another. 

Teeth  strongly  resemble  bone  in  their  composition. 
They  are  composed  of  animal  and  mineral  elements. 
The  mineral  matter  is  the  more  abundant  of  the  two, 
and  consists  principally  of  lime  salts,  such  as  phosphate 
of  lime,  carbonate  of  lime,  fluoride  of  calcium,  and 
phosphate  of  magnesia.  These  elements  give  to  the 
teeth  their  strength  and  hardness.  If  they  are  absent 
to  any  marked  extent,  the  teeth  are  weak,  frail  and  soft. 

By  careful  experiment,  it  has  been  found  that  the 
following  foods  contain  these  elements  in  greatest  abun- 
dance : 

Milk.— This  is  the  representative  food,  as  it  contains 
every  element  which  enters  into  the  structure  of  the 


ADVICE  TO  MOTHERS.  49 

body ;  but  as  it  is  a  ready  absorbent  of  microbes,  it 
should  be  boiled  before  it  is  given  to  children.  The 
boiling  kills  the  microbes. 

Buttermilk. — This  is  valuable  as  a  food,  except  when 
it  is  churned  from  very  sour  milk,  or  has  become  cheesy 
by  age. 

Cheese. — This  should  be  eaten  sparingly,  as  it  is  indi- 
gestible ;  a  little,  however,  may  aid  digestion. 

The  Cereals. — Wheat,  maize,  rye,  oats  and  rice,  are 
very  valuable  foods,  because  they  contain  so  many  of 
the  constituents  needed  for  life  and  health. 

Fine  flour,  however,  sbould  be  sparingly  used,  because 
in  its  preparation  the  lime  salts  and  phosphates  are 
extracted.  Thus,  it  has  been  estimated  that  five  hun- 
dred pounds  of  Graham  flour  contain  seventy-five 
pounds  of  muscle,  and  eighty -five  pounds  of  bone  ma- 
terial, while  an  equal  quantity  of  white  flour  contains 
only  sixty-five  pounds  of  muscle,  and  but  fifty  pounds  of 
bone  material. 

Eggs. — These  are  highly  nourishing.  They  should  be 
used  "soft-boiled,"  and  not  hard-boiled,  as  the  latter 
are  less  digestible.  Eggs  should  always  be  eaten  with  a 
little  bread  and  salt,  as  this  renders  them  more  whole- 
some. 

Meat. — Of  all  meats,  beef  and  mutton  are  the  best 
regular  foods.  If  rightly  prepared,  meat  is  very  nour- 
ishing and  digestible.     Among  other  nourishing  meats 


50  CARE  OF  THE  TEETH  AND  MOUTH. 

might  be  mentioned  pork,  veal  and  poultry.  Meat, 
however,  should  not  be  eaten  excessively,  and  should 
never  be  used  unless  carefully  prepared. 

Fish. — When  fresh  and  well  cooked,  fish  are  very 
nourishing. 

Beans, — The  nutritive  value  of  beans  is  higher  than 
that  of  any  other  vegetable.  Among  the  most  valuable 
varieties  may  be  mentioned  the  kidney,  the  haricot  and 
the  lima. 

Peas. — Peas  have  Qualities  similar  to  beans,  but  not 

JL  J 

in  the  same  degree. 

Potatoes. — If  properly  cooked,  these  make  a  valuable 
food.  When  cold  they  are  indigestible.  They  are  best 
when  boiled  with  the  skin  on,  or  when  roasted.  Pota- 
toes contain  valuable  potash  salts,  which  are  lost  in 
boiling  without  the  skins,  but  are  retained  in  baking 
and  stewing. 

Vegetables. — Cabbage,  parsnips,  carrots,  onions,  to- 
matoes and  beets  are  good  foods  when  eaten  moderately, 
but  if  taken  in  large  quantities  are  indigestible. 

These  are  but  a  few  of  the  many  valuable  foods 
which  a  bountiful  nature  has  placed  at  man's  disposal. 
Only  those  are  enumerated  in  the  above  list  which  are 
important  from  the  standpoint  of  the  teeth.  They  are 
equally  valuable,  however,  in  building  up  the  rest  of 
the  body.  For  a  more  extended  discussion  of  food,  I 
refer  the  reader  to  some  work  on  hygiene.     In  our 


ADVICE  TO  MOTHERS.  51 

libraries  may  be  found  many  books  treating  of  this  topic 
most  exhaustively  and  explicitly.  Their  perusal  will 
repay  the  reader  with  compound  interest. 

The  consequences  which  result  from  a  neglect  to  use 
proper  food  cannot  be  overstated.  It  is  because  of  this 
neglect  that  so  many  of  oui'  boys  and  girls,  while  yet 
in  the  full  bloom  of  youth,  are  compelled  to  wear  arti- 
ficial dentures.  One  eminent  writer  has  even  said, 
"  We  are  becoming  a  toothless  people."  Of  course  he 
did  not  imply  that  our  ancestors  did  not  suffer  from 
decayed  teeth.  The}^  certainly  did,  but  through  an  ex- 
amination of  their  remains,  we  must  conclude  that  the}^ 
did  not  suffer  from  dental  troubles  to  the  extent  that 
we  do. 

Our  inventions  and  discoveries  have  revolutionized 
science  and  art.  They  have  even  changed  the  character 
of  our  food.  The  tables  of  the  rich  are  to-day  loaded 
with  delicate,  dainty  viands,  from  which  have  been  ex- 
tracted the  phosphates  and  lime  salts,  the  elements  that 
build  up  the  bones  and  the  teeth.  It  is  because  he  eats 
such  food  that  the  child  of  riches  often  has  weak,  ill- 
formed  teeth,  and  because  the  child  of  poverty  subsists 
on  coarse  flour,  he  enjoys  a  wealth  of  teeth  that  money 
cannot  buy. 

Having  now  learned  "  What  to  eat,"  we  have  yet  to 
learn  what  few,  indeed,  understand,  "  How  to  eat,"  for 
the  evils  resulting  from  a  neglect  of   the  latter    will 


52  CARE  OF  THE  TEETH  AND  MOUTH. 

more  than  balance  the  good  derived  from  an  observance 
of  the  former. 

How  TO  Eat. — However  nourishing  may  be  the  food 
one  eats,  it  can  yield  little  benefit  unless  it  is  properly 
eaten. 

1.  It  is  to  be  thoroughly  masticated. 

2.  It  should  not  be  taken  in  excess,  nor  the 
maxim  forgotten,  "  We  eat  to  live,  and  do  not  live  to 
eat." 

3.  It  is  not  to  be  taken  too  hot  or  too  cold. 

4.  The  stomach  must  be  allowed  freedom  of  move- 
ment. 

It  is  self-evident  that  if  the  stomach  is  overloaded 
by  excessive  eating,  or  if  the  food  is  bolted  and  not 
thoroughly  masticated,  the  work  of  digestion  will  be 
poorly  performed,  the  stomach  become  disordered,  and 
the  saliva  acidified.  The  acid  saliva,  as  already  shown, 
destroys  the  teeth. 

It  is  equally  evident  that  since  the  food  digests  most 
readily  at  a  temperature  of  about  98°  F.,  if  that  which 
is  very  cold  or  warm  is  taken  into  the  stomach,  its  tem- 
perature is  materially  lowered  or  raised,  and  to  that 
extent  the  work  of  digestion  is  checked. 

Nor  need  I  add  that  if  the  free  movement  of  the 
stomach  is  restrained  by  stays  or  tight  corsets,  it  can- 
not perform  its  functions  properly.  ]^o  doubt  a 
slender  waist  gives  to  a  woman  an  elegant  form,  but  a 


ADVICE  TO  MOTHERS.  53 

gracefulness  purchased  at  the  price  of  health  is  a  charm 
far  too  costly. 

Hints  to  Pregnant  Women. 

Women  at  this  time  must  be  particularly  careful  to 
observe  hygienic  laws,  because  upon  their  obedience 
to  them  depends  not  only  their  own  health,  but  also 
that  of  the  unborn  child.  The  food,  especially,  should 
be  highly  nourishing,  because  only  a  part  of  it  is  em- 
ployed in  building  up  her  own  body,  the  remainder 
going  to  lay  a  foundation  for  the  organs  of  her  child. 
If,  for  instance,  her  food  is  deficient  in  lime  salts  and 
phosphates,  not  only  will  her  own  teeth  be  underfed, 
but  she  will  give  but  a  poor  structure  to  the  teeth  of 
her  young. 

Every  married  woman  should  have  her  teeth  care- 
fully attended  to,  for  any  trouble  with  which  they 
may  be  affected  will  be  intensified  by  her  pregnancy. 
At  no  other  period  of  a  woman's  life  do  her  teeth 
decay  more  rapidly.  At  no  other  time  is  she  so  suscep- 
tible to  disease,  so  frequently  indisposed,  so  neglectful 
of  herself.  She  is  a  constant  sufferer  from  disorders  of 
the  stomach,  and  in  particular  from  morning  sickness, 
or  inability  to  retain  food.  As  a  result,  her  saliva  is 
generally  acid,  and  hence  her  teeth  are  rapidly  de- 
stroyed. 

As  I  can  only  treat  of  the  laws  of  health  in  so  far  as 


54  CAKE  OF  THE  TEETH  AND  MOUTH. 

they  directly  affect  the  teeth,  I  must  stop  here,  for  a 
more  extended  discussion  would  take  me  from  the  field 
of  the  dentist  into  the  domain  of  the  physician.  Let 
me  close,  therefore,  by  recapitulating  the  various  points 
suggested  in  this  chapter. 

1.  Let  the  mouth  be  always  clean. 

2.  Masticate  the  food  thoroughly. 

3.  Eat  moderately  ;  avoid  excess. 

4r.     We  eat  to  live ;  we  do  not  live  to  eat. 

5.  Eat  substantial,  well-cooked  food. 

6.  Avoid  pastry  and  superfine  flour. 

7.  Do  not  eat  very  cold  or  very  warm  food, 

8.  Do  not  restrict  the  action  of  the  stomach  by 
corsets  or  stays. 

9.  To  neutralize  the  acidity  of  the  mouth  use  lime 
water. 

10.  To  relieve  morning  sickness,  use  Lacto-Phosphate 
of  Lime. 

This  last  named  remedy,  used  in  the  form  of  the 
syrup,  should  be  freely  employed  by  expectant  mothers, 
unless  otherwise  ordered  by  their  physician.  It  should 
be  taken  in  teaspoonful  doses,  three  times  daily.  It  is 
especially  valuable  because : 

1.  It  assists  in  retaining  the  food  on  the  stomach. 

2.  It  relieves  the  morning  sickness,  or  vomiting,  to 
which  women  are  so  subject  at  this  critical  period  of 
their  lives. 


ADVICE  TO  MOTHERS. 


55 


3.  It  strengthens  the  mother's  teeth,  and  contributes 
to  the  perfect  development  of  those  of  her  unborn 
child. 

It  is  particularly  useful  in  those  cases  in  which  the 
food  is  deficient  in  lime  salts.  Lime  water,  taken  in 
moderate  doses,  is  another  remedy  very  efficient  in 
hardening  the  teeth.  It  may  also  be  used  as  a  mouth 
wash,  after  each  meal. 

A  solution  of  bicarbonate  of  soda  makes  another  ex- 
cellent mouth  wash,  using  a  teaspoonfid  in  a  glass  of 
water  after  each  meal.  Both  will  neutralize  the  acidity 
of  the  mouth,  which  is  so  common  at  this  period  of  the 
life  of  woman. 


A  case  of  irregularity  of  the  teeth. 


CHAPTEK  VII. 

childbbn's  teeth. 

By  a  natural  progression  we  are  brought  to  the  con- 
sideration of  children's  teeth.  After  the  mother  has 
secured  to  her  child  a  solid  foundation,  her  work  has 
but  begun.  As  soon  as  the  teeth  appear  they  must  be 
carefully  watched,  for  as  they  take  some  time  to  solidify, 
they  easily  decay  ;  as  to  the  best  means  for  preserving 
these  organs,  there  is  much  misunderstanding  and  lack 
of  knowledge,  and  hence  many  a  child's  teeth  are  un- 
wittingly permitted  to  decay.  The  following  sugges- 
tions on  the  care  of  infant's  teeth  will,  therefore,  I 
think,  be  of  some  service  to  the  reader. 

Children  grow  two  sets  of  teeth.  The  milk  teeth, 
twenty  in  number,  and  the  permanent  ones,  thirty-two 
in  number. 

The  milk  teeth  generally  appear  as  follows  : 

Central  incisor, 5th  to    6th  month. 

Lateral  incisor, 7th  to    8th  month. 

First  molars, 12th  to  16  th  month. 

Canines, 14th  to  20th  month. 

Second  molars, 21st  to  36th  month. 


children's  teeth.  57 

The  eruption  of  the  lower  teeth  usually  takes  place 
before  those  of  the  upper. 

The  permanent  teeth  appear  in  the  following  order: 

First  molars, 5th  to    6th  year. 

Central  incisors,  lower  jaw,     .     .     .  6th  to    Yth  year. 

Central  incisors,  upper  jaw,  .     .     .  7th  to    8th  year. 

Lateral  incisors, 7th  to    9th  year. 

First  bicuspids, 9th  to  10th  year. 

Second  bicuspids, 10th  to  11th  year. 

Canines, 11th  to  13th  year. 

Second  molars, 12th  to  15th  year. 

Third  molars,  or  wisdom  teeth,      .  17th  to  23d  year. 

As  the  milk  teeth  last  but  a  short  time,  or  until  they 
are  displaced  by  the  permanent  teeth,  very  little  atten- 
tion is  generally  paid  to  their  preservation.  Tartar  and 
filth  are  allowed  to  accumulate,  and  as  soon  as  they 
become  troublesome  they  are  extracted. 

The  idea  that  the  milk  or  deciduous  teeth  should  be 
taken  out  as  soon  as  they  ache,  is  not  only  erroneous 
but  harmful.  So  long  as  they  can  be  saved,  they  should 
not  be  removed,  as  serious  injury  is  inflicted  on  the 
child.  If  these  are  extracted  the  incoming  permanent 
ones  are  seriously  interfered  with;  they  grow  out  of 
their  allotted  space,  or  grow  in  an  irregular  manner, 
distort  the  mouth  and  impede  the  work  of  mastication. 
Nature  indicates  the  time  for  their  removal  by  absorb- 


58 


CAEE  OF  THE  TEETH  AND  MOUTH. 


ing  their  roots  and  loosening  their  crowns,  preparatory 
to  the  appearance  of  the  permanent  teeth.  Moreover, 
it  is  somewhat  dangerous  to  extract  any  of  the  milk 
teeth,  because  the  jaw  is  not  yet  perfectly  developed, 
and  is,  therefore,  very  frail  and  liable  to  fracture.     It 


Jaws  of  a  child  at  about  six  years  of  age.     The  deciduous  teeth  and  the  first  per- 
manent molars  are  in  place.     The  outer  plate  of  the  bone  is  removed 
to  show  the  advancing  germs  of  the  permanent  teeth. 


is  because  of  this  belief  and  the  consequent  neglect  that 
the  milk  teeth  decay  so  rapidly.  As  soon  as  they 
appear,  they  should  be  cleaned  every  day  with  soft 
linen,  and  when  all  the  teeth  are  erupted,  a  soft  brush 
should  be  used.     Tartar,  easily  distinguishable  by  the 


children's  teeth.  59 

dark  or  green  stain  which  it  imparts,  should  not  be  per- 
mitted to  accumulate. 

From  the  tables  already  given,  it  appears  that  at  the 
age  of  six  the  child  has  four,  and  at  the  age  of  twelve 
it  has  twenty-eight  of  the  permanent  teeth. 

The  sixth-year  molars  deserve  a  special  notice,  because 
they  are  so  frequently  confounded  with  the  first  set  of 
teeth.  The  reason  of  this  is,  that  those  back  teeth  of 
the  upper  and  lower  jaw  on  either  side  make  their  ap- 
pearance before  any  of  the  first  teeth  are  shed.  If 
neglected,  as  they  too  often  are,  they  are  early  lost,  and 
can  never  be  replaced,  except  artificially.  "When  you 
are  able  to  count  a  row  of  eleven  or  twelve  in  each  jaw, 
that  is,  as  soon  as  there  are  more  than  twenty  teeth 
in  all,  you  may  be  sure  that  the  last  molars  on  either 
side  belong  to  tJie  second  set. 

During  the  eruption  of  the  milk  teeth,  children  fre- 
quently suffer  from  stomatitis,  or  inflammation  of  the 
soft  parts  of  the  mouth,  due  to  the  irritation  produced 
by  the  teeth  forcing  their  way  to  the  surface.  The 
raucous  membrane,  or  lining  of  the  mouth,  becomes  very 
red,  there  is  an  increased  flow  of  saliva,  the  parts 
are  irritable  and  sore,  the  child  is  in  a  feverish  state,  it 
is  disinclined  to  put  anything  in  its  mouth,  or  to  take 
food  either  from  the  spoon  or  nipple,  because  of  the 
pain  which  it  experiences.  The  irritation  and  swelling 
may  be  so  extensive  that  the  entire  nervous  system 

6 


60  CAEE  OF  THE  TEETH  AND  MOUTH. 

becomes  affected,  and  the  child  is  thrown  into  convul- 
sions. Belief  may  frequently  be  obtained  by  lancing 
the  gums,  and  thus  mitigating  the  irritating  pressure  of 
the  incoming  teeth,  and  by  spraying  the  mouth  with  a 
solution  of  fifteen  grains  of  borax,  or  chlorate  of  potas- 
sium, dissolved  in  a  tumbler  full  of  water,  or  by  paint- 
ing the  cheeks  and  lips  with  linseed. 

Of  course,  during  dentition  children  may  suffer  from 
many  other  diseases,  none  of  which  are  within  the  prov- 
ince of  the  dentist.  In  such  cases  the  physician  should 
be  consulted,  and  much  unnecessary  pain,  if  not  serious 
consequences,  may  be  avoided  by  a  timely  call. 

Yery  early  in  life  children  may  acquire  bad  habits, 
which  shall  result  in  deformity  of  the  teeth,  and  hence 
parents  should  make  a  strong  effort  to  correct  them. 

Thumb,  oe  Finger  Sucking. — By  this  habit  the  lower 
teeth  are  forced  inwards  and  the  upper  teeth  outwards. 
These  results  are  due  to  the  peculiar  way  in  which  the 
fingers  rest  upon  the  teeth  during  the  act  of  sucking. 
Unless  this  habit  is  checked  before  the  permanent  teeth 
appear,  it  will  result  in  disfiguring  them,  and  speech 
and  mastication  will  be  impaired.  The  habit  may  be 
broken  by  wrapping  the  finger  with  muslin  saturated 
with  some  harmless  preparation,  disagreeable  to  the 
taste. 

Lip  Sucking. — This  is  another  habit  which  may  result 
in  depression  of  the  lower  teeth.    The  child,  by  drawing 


children's  teeth.  61 

the  lower  lip  into  the  raouth,  exerts  a  pressure  upon  the 
teeth,  and  they  are  forced  inward  to  such  an  extent  that 
deformit}'^  results.     The  space  for  the  back  teeth  is 


An  irregular  dentition  clue  to  thumb  sucking. 

greatly  contracted,  and  extraction  of  one  or  more  is 
required  to  make  room  for  all  the  teeth  in  the  arch. 

If  the  child  cannot  be  broken  of  this  habit  in  anj^ 
other  way,  a  fixture  similar  to  a  splint  ought  to  be  made 
and  put  between  its  teeth  and  lips,  so  as  to  make  it  im- 
possible to  draw  the  lips  into  the  mouth. 

Mouth  Breathing. — Mouth  breathing  also  produces 
irregularity  of  the  teeth.  This  habit,  most  commonly 
indulged  during  sleep,  is  frequently  due  to  some  nasal 
obstruction  of  the  air  passages.  In  these  cases  surgical 
operations  are  often  necessary.  Sometimes  the  habit 
is  acquired  when  no  organic  trouble  exists.  The  most 
effective  way  of  breaking  this  habit  is  that  employed 


62  CARE  OF  THE  TEETH  AND  MOUTH. 

by  the  Indian  mother,  who  bandages  the  mouth  of  the 
child,  and  in  this  way  forces  it  to  breathe  through  the 
nostrils,  or  not  to  breathe  at  all.  Rubber  applia.nces, 
working  on  the  same  principle,  are  in  use  to-day,  only 
they  are  free  from  the  barbarous  character  of  the  Indian 
method ;  that  is,  they  work  on  the  principle  of  inducing 
nose  breathing,  by  making  it  so  difficult  to  breathe 
through  the  mouth  that  the  child  readily  accustoms 
itself  to  breathe  through  its  nostrils. 

Cracking  I^uts,  Etc. — Teeth  must  not  be  used  as 
nut-crackers.  Like  the  bones,  they  are  not  solidified  in 
early  life.  Even  if  they  are,  cracking  nuts  with  them 
will  soon  result  in  their  destruction,  as  they  were  not 
intended  for  such  violent  work. 

Candies. — Children  should  be  advised  to  abstain  from 
candies.  I  mean  cheap  candies ;  that  of  the  best  qual- 
ity is  harmless  enough,  but  the  cheap  candies  are  fre- 
quently mixed  with  acids  and  arsenic,  the  latter  being 
used  as  coloring  material.  We  need  hardly  add  that 
these  foreign  substances  are  most  destructive  in  their 
action  on  the  teeth. 

Eating. — Children  should  be  prevented  from  drinking 
very  cold  water  after  partaking  of  a  warm  meal.  With 
Americans  the  use  of  ice  water  is  very  common.  Yery 
often  after  drinking  hot  coffee  or  tea,  a  large  quantity 
of  cold  water  is  drunk.  This  mixture  of  the  warm  and 
cold  is  very  injurious,  not  only  to  the  stomach,  but  also 


childken's  teeth.  63 

to  the  teeth.  The  habit  should  be  broken  in  childhood, 
because  when  once  formed  it  is  difficult  to  overcome. 
But  unless  the  food  contains  a  generous  supply  of  tooth- 
building  material,  no  amount  of  cleanliness  or  correc- 
tion of  bad  habits  will  suffice  to  preserve  the  teeth. 

An  eminent  physician,  speaking  on  the  subject  of 
food,  says,  "our  pale-faced  boys  and  girls  are  brought 
to  this  condition  by  living  on  butter,  sugar  and  super- 
fine flour.  To  prepare  these  articles,  the  very  elements 
that  make  bone  and  tissue  are  extracted."  The  child 
must  be  fed  on  plain,  substantial  food  ;  it  must  not  be 
too  fat,  or  too  rich,  all  pastries  being  avoided.  A  tea- 
spoonful  of  lacto-phosphate  of  lime,  or  lime  water,  ad- 
ministered three  times  a  day,  will  add  greatly  to  the 
strength  of  the  child's  teeth. 

To  conclude,  let  me  say  that  as  soon  as  the  milk 
teeth  appear  the  utmost  care  should  be  taken  of  them. 
The  child  should  be  examined  by  a  dentist  at  regular 
intervals,  say  of  six  months.  It  should  not  have  any 
of  the  temporary  teeth  extracted,  but  have  them  filled 
wherever  necessary,  and  so  preserve  them  until  the 
permanent  teeth  are  erupted. 

By  following  these  suggestions  and  bringing  to  their 
aid  good  common  sense,  mothers  may  secure  to  their 
children  a  set  of  strong,  healthy  teeth,  which,  with 
proper  care,  will  last  a  life-time. 


CHAPTER  YIII. 


CEOWN  AND  BRIDGE  WORK. 


Although  this  department  of  dental  practice  offers 
to  humanity  one  of  the  most  useful  and  ornamental 
devices  yet  discovered,  very  little,  as  yet,  is  known  of 
it  among  the  people.  By  its  employment,  teeth  that 
it  would  otherwise  be  necessary  to  extract  are  pre- 
served, and  artificial  plates  are  dispensed  with.     It  is 

certainl}'-  more  expensive  than 
artificial  dentures,  but  the 
comfort  and  convenience  af- 
forded, to  say  nothing  of 
durability,  amply  repay  the 
outlay. 

Crown  Work. — This  is  the 
process  of  attaching  artificial 
crowns  to  badly  decayed 
teeth,  or  to  roots.  There  are 
a  number  of  kinds  of  crowns 
used.  Those  intended  for 
teeth  in  the  anterior  part  of  the  mouth  are  of 
porcelain,    or    have    porcelain     facings,    while    those 


Crowns  for  front  teeth. 


CKOWN    AND    BRIDGE    WORK. 


65 


employed  for  back  teeth  alone  are  commonly  made 
of  gold  only. 

The  latter  class  are  caps  of  crold,  which  completely 
envelop  and  enclose  the  crowm  of  the  tooth,  and  they 
are  used  in  those  cases  in  which  decay  has  so  wrecked 
them  that  a  filling  will  fail  to  preserve  them  in  a  satis- 
factory condition.  Surrounded  by  its  gold  cap,  the 
tooth  cannot  come  into  contact  with  foreign  substances, 
so  that  it  is  almost  impossible  for  decay  to  recur. 

For  front  teeth,  crowns  with  porcelain  facings  are 
employed,  to  prevent  the  unsightly  appearance  of 
such  an  apparent  mass  of  metal.  The  porcelain  facing 
gives  to  the  tooth  a  natural  appearance. 

Formerly,   the  work  of    crowning,  which  demands 


Crowns  for  back  teeth. 


great  skill  and  discrimination,  was  confined  mainly  to 
the  back  teeth;  but  the  modern  dentist,  having  im- 
proved methods  of  manipulation,  successfully  operates 


66  CAKE  OF  THE  TEETH  AND  MOUTH. 

on  any  tooth,  if  it  have  but  roots  which  are  firmly 

imbedded  in  the  jaw. 

Bkidge  Wokk. — When  there  are  two  or  more  sound 

roots  or  teeth,  with  spaces  from  which  teeth  have  been 

lost  between  them,  it  is  possible  to  supply  the  missing 

teeth  by  constructing  a  bridge  of  crowns  across  the 

vacancy. 

The  crowns  are  soldered  to  each  other,  the  terminal 

ones  being  firmly  attached  to  the  sound  teeth  or  roots, 
in  such  manner  that  each  of  the  intermediate 
crowns  occupies  the  space  of  a  missing  tooth. 
They  may  be  constructed  with  a  porcelain 
facing,  so  that  the  whole  work  shall  present 
to  the  observer  a  most  natural  appearance. 
There  are  a  variety  of  methods  for  construct- 
ing these  bridges,  each  excellent  in  itself,  and 
each  specially  adapted  to  some  particular  class 

.nrtmciai 
Crown.        of  CaSCS. 

Bridge  work  has  been  condemned  by  many  dentists 
of  high  standing,  because  it  has  been  so  much  abused 
through  its  improper  use.  Some  practitioners,  either 
because  of  a  mistaken  enthusiasm  or  from  some  less 
worthy  motive,  have  inserted  bridges  upon  insecure  or 
diseased  roots,  with  the  natural  consequence  of  their 
earl}^  failure.  Others  have  not  hesitated  to  sacrifice 
good  and  serviceable  teeth  for  the  purpose  of  putting  in 
bridges.     All  these  possible  abuses  do  not  excuse  the 


CROWN    AND    BRIDGE    V»ORK. 


67 


wholesale  denunciations  of  that  which  is  proper  and 
correct  practice.     As  well  might  one  condemn  the  fill- 
ing of   teeth,  because  poor  work  is  sometimes  done. 
One  of  the  most  attractive  features  of  this  kind  of 


A  p.ece  of  Bridge  Work. 

work  is,  that  when  properly  made  and  inserted,  the 
patient  soon  loses  all  consciousness  of  its  artificiality. 
The  crowns  and  teeth  being  attached  to  natural  roots 
and  immovable,  approach  more  nearly  to  the  natural 
organs,  and  the  patient  suffers  less  discomfort  than 
from  an}^  other  artificial  substitutes. 


CHAPTER  IX. 

FKACTUKED   JAWS. 

To  the  great  majority  of  people,  the  word  "  dentist " 
conveys  but  one  idea — that  of  a  tooth  puller.  It  is 
true  that  in  the  past,  dentistry  was  practised  to  a  large 
extent  by  persons  engaged  in  some  other  pursuit,  and 
without  any  professional  education  whatever.  The 
blacksmith,  barber,  watchmaker,  and  others  of  the 
same  class,  were  the  dentists  of  every  village  and  town. 
Even  in  some  of  our  largest  cities,  dentists  of  this  kind 
were,  until  quite  lately,  found  practising  under  the  very 
shadows  of  the  Universities  and  Medical  schools.  The 
explanation  of  this  seems  to  be  that  mere  tooth  drawing 
constituted  the  surgical  dentistry  of  those  days,  and  as 
the  operation  of  extraction  is  one  requiring  muscular 
strength  and  manual  dexterity,  rather  than  anatomical 
knowledge  and  surgical  skill,  and  was  performed  as 
successfully  by  the  irregular  as  by  the  regular  practi- 
tioner, it  had  not  many  attractions  for  medical  men. 
Dentistry  was,  accordingly,  assigned  to  the  uneducated 
and  the  charlatan. 

To-day,  however,  the  province  of  dentistry  embraces 


FRACTrRED  JAWS. 


69 


the  art  of  treating  the  diseases  and  lesions  of  the  teeth, 
and  supplying  artificial  substitutes  for  these  organs 
when  lost.  Diseases  of  the  teeth  and  mouth  are  not 
always  local  affections,  but  may,  and  very  frequently 
do,  arise  from  constitutional  causes ;  hence  the  dentist 
who  is  thoroughly  qualified  to  heal,  as  well  as  to  repair 
and  ameliorate,  must  be  both  a  surgeon  and  a  physi- 
cian. He  must  be  skilled, 
not  only  in  the  mechanical, 
but  also  in  the  therapeutical 
department  of  his  profes- 
sion. As  a  result,  many 
affections  of  the  teeth  and 
the  various  portions  of  the 
mouth,  for  the  treatment  of 
which  people  in  former 
Interdental  si.iiut.  ^j^^^^   j^^^^l   recoursc  to  the 

physician  or  the  surgeon,  to-day  more  properly  are  rel- 
egated to  the  dentist,  who,  making  a  specialty  of  these 
parts,  is  thoroughly  familiar  with  them,  and  can  prop- 
erly be  termed  a  specialist  in  diseases  of  the  mouth. 

Tills  fact  is  so  well  appreciated  by  the  general  prac- 
titioners in  medicine  and  surgery,  that  they  have  no 
hesitancy  in  referring  their  patients  to  the  dentist  in 
every  case  of  oral  disease,  independent  of  any  affection 
of  the  teeth,  and  particularly  is  this  the  case  in  frac- 
tures. 


70  CARE  OF  THE  TEETH  AND  MOUTH. 

Feactueed  Jaws. — In  discussing  this  subject,  I  wish 
at  the  outset  to  mention  the  fact  that  they  are  most 
frequently  due  to  direct  manual  blows  received  in  fio-hts. 
They  may  also  be  the  result  of  kicks,  falls  and  other 
forms  of  violence.  Fractures  of  the  lower  jaw  are 
most  frequent,  those  of  the  upper  jaw  being  rarely  en- 
countered. 

The  lower  jaw  has  its  weakest  place  between  the 
canine  and  bicuspid  teeth,  owing  to  the  long  roots  of 
the  former,  and  it  is  at  this  point  that  fractures  are 
most  often  met,  although  they  may  occur  in  any  other 
part  of  the  bone.  Out  of  a  great  number  of  fractured 
jaws  that  have  been  under  my  treatment,  four-fifths 
were  due  to  violent  blows  received  during  quarrels,  the 
remaining  one-fifth  occurring  through  accidents.  In 
most  of  these  cases  the  jaw  was  fractured  between  the 
canine  and  bicuspid  teeth. 

In  newly  fractured  jaws  there  is  a  slight  movement 
of  the  broken  parts,  which  can  be  felt  by  pressing  them 
with  the  fingers.  The  simplest  method  of  detecting  a 
fracture  is  as  follows : 

Grasp  the  jaw  with  both  hands,  applied  on  each  side 
of  the  apparent  seat  of  injury,  so  as  to  hold  the  bone 
between  the  thumb  and  index  fingers ;  then,  by  slight 
opposite  movements  directed  both  upward  and  down- 
ward, a  positive  conclusion  may  be  reached  through  the 
mobility  of  the  parts.     In  badly  fractured  jaws  the 


FKACTURED  JAWS. 


71 


teeth  are  irregular,  owing  to  the  alteration  of  the  level 
of  the  fractured  parts,  and  when  the  jaws  are  brought 
together  they  do  not  meet  as  formerly,  while  very  fre- 
quently the  jaws  cannot  be  closed  at  all.  On  the  slight- 
est pressure  or  movement  severe  pain  is  felt,  and  inflam- 
mation, and  usually  suppuration,  succeed. 

The  jaw  should  be  kept  at  rest,  and  all  irritation  of 
the  fractured  parts  through  movements  caused  by  con- 
versation, eating,  etc.,  should  be  carefully  avoided.     No 


Interdental  Splint.     View  of  upper 
surface. 


Interdental  Splint.     View  of  under 
surface. 


time  should  be  lost  in  visiting  the  dentist,  for  the  more 
recent  the  fracture  the  more  readily  can  it  be  reduced, 
and  the  more  rapid  will  be  the  healing  process.  For 
the  treatment  of  fractured  jaws  the  interdental  splint 
has  been  devised,  by  the  aid  of  which  they  are  quickly 
and  easily  healed. 

This  splint  is  made  in  the  shape  of  a  horseshoe,  so  as 
to  correspond  precisely  to  the  arches  of  both  the  upper 


72 


CAKE  OF  THE  TEETH  AND  MOUTH. 


and  lower  jaws.  The  two  wide  surfaces  have  depres- 
sions into  which,  when  it  is  placed  between  the  two 
arches,  the  crowns  of  the  upper  and  lower  teeth  fit  ac- 
curately. That  is,  the  crowns  of  the  superior  teeth  fit 
into  depressions  in  the  upper  surface  of  the  splint, 
while  the  crowns  of  the  inferior  teeth  are  in  the  same 

manner  received  by  the 
lower  surface  of  this  appli- 
ance. Thus,  when  the  splint 
is  placed  in  the  mouth,  the 
teeth  and  jaws  become 
locked  and  immovable. 

In  the  centre  of  the  splint 
there  is  an  opening  for  the 
reception     of     fluid     food. 
Nature  unites  the  fractured 
bone  by  the  formation    of 
new  bone  around   and   be- 
tween  the    broken    parts, 
when     they     are    brought 
into   accurate  coaptation  and  kept  immovable  for  a 
certain    time,    and  preserved   in  good   hygienic  con- 
dition. 

In  compliance  Avith  these  principles,  all  interdental 
splints  are  constructed  to  fit  the  mouth  as  though  no 
fracture  had  occurred.  "When  such  a  splint  is  applied  to 
the  mouth,  the  fractured  parts  must,  of  necessity,  by  a 


Splint  retained  by  a  skull  cap. 


FRACTURED  JAWS.  73 

slight  pressure,  resume  their  original  position,  and  then 
nature  does  the  rest. 

It  usually  takes  from  three  to  six  weeks  for  a  perfect 
union  to  be  effected.  I  have  dwelt  at  some  length  on 
fractures  and  splints,  because  I  wish,  first,  to  show  how 
easily  a  fractured  jaw  can  be  healed  through  the  aid  of 
a  splint,  and  secondly,  to  dissipate  the  distrust  with 
which  some  people  are  apt  to  regard  those  dental  sur- 
geons who  undertake  to  perform  such  operations.  To 
illustrate  the  second  point  more  forcibly,  I  will  relate 
the  following  case : 

A  short  time  ago  a  lad,  four  or  five  years  of  age, 
was  kicked  by  a  horse,  and  his  lower  jaw  was  broken. 
I  was  called  in  as  consulting  dentist,  and  suggested  the 
use  of  the  splint.  As  the  parents  had  never  heard  of 
this  device,  they  immediately  became  distrustful,  and  by 
their  misgivings  and  fretfulness  greatly  interfered  with 
the  Avork  of  fitting  the  splint.  Even  after  it  had  been 
introduced  into  the  child's  mouth,  it  was  with  the  ut- 
most difficulty  that  they  were  prevented  from  removing 
it.  In  the  course  of  a  few  weeks  tlie  fracture  was  com- 
pletely healed,  and  I  may  add  that  the  parents  were 
thoroughly  cured  of  their  distrust. 


CHAPTER  X. 


CLEFT   PALATES. 


IJ^atuke's  freaks  are  so  numerous  and  unlooked  for 
that  her  infaUibihty  becomes  a  matter  of  grave  suspi- 
cion. The  deaf,  the  mute,  the  lame  and  the  afflicted, 
daily  born  into  the  world,  are  examples  of  her  many 
whims  and  caprices.     Were  it  not  for  the  unwearied 

efforts  of  science,  these  unfor- 
tunate victims  would  find  life 
well  nigh  intolerable. 

Thanks,  however,  to  a  broad 
philanthropy,  the  blind  can  be 
taught  to  read  and  to  write,  the 
deaf  and  dumb  to  communicate 
with  those  about  them,  while 
the  deformed  are  enabled  in  a 
great  measure  to  overcome  their 
natural  defects  and  to  be  placed  upon  the  same  level 
with  their  neighbors. 

Few,  if  any,  are  more  entitled  to  our  sympathy  and 
our  best  efforts  for  relief  than  those  unfortunate  ones 
who  are  born  into  the  world  with  a  defective  palate,  for 


Jaw  with  double  cleft. 


CLEFT  PALATES. 


Y5 


the}^  are  thereby  deprived  of  one  of  the  greatest  bless- 
ings bestowed  upon  man,  the  faculty  of  distinct  speech, 
as  well  as  the  power  properly  to  perform  the  functions 
of  mastication  and  deglutition. 

The  palate  is  the  roof  of  the  mouth.  It  consists  of 
two  parts,  the  hard  and  the  soft  palate.  The  former  is 
of  bony,  while  the  latter  of  muscular  tissue.  The  hard 
palate  serves  not  only  as  the  roof  of  the  mouth,  but 
also  as  the  floor  of  the  nose.  The  soft  palate  is  sus- 
pended like  a  curtain  from  the  posterior  edge  of  the 
hard  palate. 

Its  function  is  ver}'^  important,  and  consists,  during 
deglutition,  in  closing  the  passage  from  the  pharynx 
into  the  'posterior  nares,  so  that  food  may  not  get  into 
the  nose. 

Each  palate  is,  moreover,  divided  into  two  parts, 
which  are  united  in  the  median  line  of  the  mouth.  The 
union  of  these  parts  generally  occurs  during  the  third 
week  of  embryonic  life.  Sometimes,  however,  this 
does  not  take  place,  and  the  child  is  born  with  a  perfor- 
ated palate.  Such  an  one  is  technically  called  a  con- 
genital cleft  palate. 

There  are  also  accidental  cleft  palates,  due  to  disease 
resulting  from  an  irregular  and  debauched  life.  Cleft 
palates  of  the  latter  class  are  much  more  numerous  than 
those  of  the  former.  Congenital  cleft  palates  vary  in 
size  and  form.     Sometimes  both  hard  and  soft  palates 


76  CARE  OF  THE  TEETH  AND  MOUTH. 

are  perforated.  In  such  cases  the  interior  of  the  nose 
and  the  bones  of  the  skull  are  exposed,  and  the  whole 
presents  a  very  ghastly  appearance. 

Accidental,  or  acquired,  cleft  palates  also  vary,  and 
either  the  soft  or  hard  tissues,  or  both,  may  be  affected. 


Cleft  through  the  hard  and  soft  palates. 

In  congenital  cases  the  sufferer  does  not  experience 
any  great  inconvenience  during  the  process  of  degluti- 
tion, as  the  instinct  of  self-preservation  has  from  child- 
hood taught  the  sufferer  to  close  the  cleft  with  the 
tongue.     Then,  by  placing  the  food  under  that  organ, 


CLEFT  PALATES. 


77 


it  is  shifted  from  side  to  side  until  forced  into  the 
pharynx.  This  process  is  a  very  curious  and  compli- 
cated one.  ISTone  of  us,  try  as  hard  as  he  may,  could 
imitate  it.  For  this  reason,  if  one  becomes  afflicted 
with  such  a  palate  in  adult  life,  he  can  in  no  way  accus- 
tom himself  to  close  the  opening  with  his  tongue,  and, 
therefore,  whenever  he  at- 
tempts to  eat,  a  portion  of 
the  food  is  invariably  forced 
into  the  nose.  The  patient 
thus  not  only  suffers  great 
inconvenience,  but  it  be- 
comes the  source  of  con- 
stant humiliation. 

But  by  far  the  greatest 
embarrassment  to  Avhich 
these  sufferers  are  subject- 
ed, whether  the  cleft  be  con- 
genital or  acquired,  arises 
from  their  inability  to 
speak  clearly  and  distinctly. 


Upper  denture  with  artificial  soft  palate. 


For  a  distinct  utterance  of 

vocal  sounds  every  part  of 

the  mouth  is  essential.     In  many  cases,  indeed,  the  cleft 

makes  speech  utterly  impossible. 

Formerly,  to  remedy  these  evils  recourse  was  had  to 
surgical    operation.       Staphylorraphy,    which    means 


78  CAKE  OF  THE  TEETH  AND  MOUTH. 

suturing  or  sewing  together,  was  the  most  common 
remedial  measure.  But  this  operation  in  many  cases 
proved  unsuccessful. 

It  consisted  in  paring  the  edges  of  the  cleft,  and  then 
sewing  them  together.  This  necessitated  the  stretching 
of  the  soft  parts  to  such  a  degree  that  they  would 
eventually  rupture.  Dentistry  has  succeeded  in  con- 
structing an  appliance  which,  by  taking  the  place  of 
the  lost  parts,  enables  the  palate  properly  to  perform  its 
functions.  These  contrivances  are  known  under  the 
name  of  obturators. 

Where  the  hard  palate  alone  is  perforated,  the  obtur- 
ator is  very  simple.  It  consists  of  an  ordinary  artificial 
plate,  extending  over  the  cleft. 

But  where  the  soft  palate  is  involved,  it  is  very  com- 
plicated and  diflBcult  of  construction.  In  such  cases 
the  obturator  consists  of   an  artificial  plate,   to  the 

posterior  edge  of 
which  is  attached  a 
pendulous  body,  cor- 
responding in  size 
and  shape  to  the  miss- 
ing soft  palate,  and 
fitting  exactly  in  its 

Plate  ready  for  attachment  of  the  obturator  part,      vjlopp 

In  some  cases  this  pendulous  body  is  given  a  hinge 
movement,  the  muscles  of  the  mouth  enabling  it  to 


CLEFT  PALATES. 


79 


perform  all  the  functions  of  the  soft  palate.  The  obtur- 
ators are  held  in  position  bv  means  of  clasps  or  rings, 
which  embrace  the  natural  teeth,  as  it  is  impossible, 
OTving  to  the  cleft,  to  utilize  the  forces  of  adhesion  and 
atmospheric  pressure,  as  would  be  done  in  the  case  of 
artificial  dentures. 

The  use  of  the  obturator  has  never  failed  to  restore 
clearness  and  distinctness  to 
speech,  or  the  power  properly 
to  perform  the  process  of 
deglutition.  Of  course,  in 
congenital  clefts,  the  sufferer 
has  never  known  how  to 
litter  the  proper  sounds,  and 
for  this  reason  it  requires  a 
great  deal  of  patience  and 
perseverance  on  his  part  be- 
fore he  is  able  to  do  so.  lie 
must  learn  just  hke  a  young- 
child.  But  in  the  case  of 
acquired  clefts,  the  patient 
still  retains  the  knowledge 
of  the  former  method  of 
utterance ;  he  only  needs  some  contrivance  to  close 
up  the  cleft,  to  restore  to  him  the  power  of  speech.  So 
it  can  readily  be  seen  that  when  the  palates,  or  either 
of  them,  is  perforated,  the  plate  and  the  pendulous  body 


An  obturator. 


80  CARE  OF  THE  TEETH  AND  MOUTH. 

thereto  attached,  if  properly  made,  will  completely 
close  the  entrance  to  the  nose  and  prevent  the  food 
from  being  forced  into  it. 

The  obturator  is  an  excellent  example  of  the  many 
benefits  modern  dentistry  has  conferred  upon  mankind. 
By  its  means  men  are  restored  to  society,  who,  either 
through  the  misfortune  of  birth  or  from  wantonness, 
have  become  to  others  an  object  of  pity — to  themselves, 
one  of  disgust. 


CHAPTEE  XI. 


HINTS   ON   HOME   REMEDIES. 


People  are  frequently  seized  with  toothache  at  times 
when  it  is  almost  impossible  to  visit  the  dentist.  On 
such  occasions  they  listen  eagerly  to  the  advice  of  kind 
and  sympathetic  friends,  each  of  whom  has  some  pet 
medicine  to  recommend  that  he  is  convinced  will  prove 
efficacious ;  these  remedies  too  often  are  only  active  in 
burning  the  patient's  mouth,  so  when  one  of  these  self- 
doctored  sufferers  obtains  professional  advice,  the  tissues 
are  so  inflamed  that  before  the  teeth  can  be  treated  the 
work  of  home  doctoring  must  be  undone. 

Recognizing  the  difficulties  under  which  one  labors 
who  is  thus  suddenly  attacked,  I  have  determined  in 
this  chapter  to  lay  down  a  few  suggestions,  which,  if 
properly  followed,  will  enable  patients  to  treat  them- 
selves in  an  intelhgent  and  effective  manner  until  they 
can  reach  the  dentist.  Of  course,  in  a  book  such 
as  this,  it  is  impossible  to  speak  of  every  disease  that 
may  affect  the  teeth.  To  attempt  it  would  result  in 
producing  a  work  not  only  very  voluminous,  but  also 
very  confusing,  as  the  distinctions  between  many  of 


82  CAEE  OF  THE  TEETH  AND  MOUTH. 

the  disorders  are  very  subtle,  and  comprehensible  only 
to  the  dentist.  There  are  others,  however,  whose 
cause  even  a  layman  can  readily  ascertain,  and  to 
which  some  simple  remedy  may  be  temporarily  ap- 
plied with  good  effect.  I  shall  treat  in  this  chapter  of 
the  following  maladies : 

I.     Aching  teeth,  with   a  cavity  caused  by  decay. 
Of  these  there  are  two  classes  : 

A.  When   the  pulp  within  the  cavity  is 
living. 

B.  When   the  pulp   within   the   cavity  is 
dead. 


II. 

Filled  teeth  that  ache.     Of  these  there  are  two 

classes : 

A.     When  the  pulp  is  hving. 

B.     When  the  pulp  is  dead. 

III. 

Aching  gums.     These  are  usually  due  to  one  of 

the  following  causes : 

A.     Tartar. 

B.     A  cold. 

C.     Kecent  cleaning  of  teeth. 

D.    Extraction  of  teeth. 

IV. 

Hemorrhage. 

y. 

JN^euralgia. 

YI. 

Foul  breath. 

HINTS  ON  HOME  REMEDIES.  83 

YII.     Dislocated  jaw. 
VIII.     Faintness  after  extraction. 
IX.     Food  to  be  used  in  place  of  solid  food. 

When  suffering  from  toothache,  find  out  if  any  of 
the  teeth  have  a  cavity  ;  you  can  do  this  by  probing 
the  teeth  with  an  ordinary  tooth-pick,  or  some  similar 
instrument.  If  you  discover  a  cavity,  determine 
whether  the  pulp  within  the  cavity  is  living  or  dead. 

I.    Aching  Teeth  with  a  Cavity  of  Decay. 

A.       WHEN    the    pulp    IS    LIVING. 

Diagnosis. — To  determine  whether  the  pulp  is  living 
or  dead,  take  some  very  warm  or  very  cold  water  in 
the  mouth,  and  bring  it  in  contact  with  the  pulp.  If 
the  pain  is  thereby  increased,  the  pulp  is  living. 
Another  very  sim])]e  method  for  determining  whether 
the  pulp  is  living  or  not,  is  to  insert  a  tooth-pick  into 
the  cavity  and  press  upon  the  pulp.  If  the  pain 
thereby  is  intensified,  the  pulp  is  living.  In  fact, 
living  pulps  are  so  sensitive  that  the  introduction  of 
any  foreign  material  into  the  cavity  will  greatly 
increase  the  suffering. 

Treatment. — "Wash  out  the  cavity,  either  by  rinsing 
the  mouth  with  lukewarm  water,  or  by  employing  a 
syringe,   if    one   is    at    hand.      After    the    cavity    is 

8 


84  CAEE  OF  THE  TEETH  AND  MOTJTH. 

thoroughly  cleaned,  insert  into  it  a  pellet,  or  little  ball 
of  cotton,  saturated  with  spirits  of  camphor,  oil  of 
cloves  or  laudanum.  Over  the  pellet  insert  a  piece  of 
dry  cotton,  so  as  completely  to  fill  the  cavity,  and 
thus  protect  the  pulp  from  sudden  changes  of  tempera- 
ture, or  the  intrusion  of  foreign  substances. 

B.       ACHmG   TEETH,  WHEN    THE   PULP   IS   DEAD. 

Diagnosis. — Of  these  teeth  there  are  two  kmds ;  in 
the  first,  the  patient  suffers  from  mere  inflammation  of 
the  lining  membrane  between  the  root  and  the  socket ; 
in  the  second,  the  inflammation  has  developed  an 
abscess  or  gumboil.  Prompt  treatment  in  the  first 
stage  of  the  disease  may  prevent  the  second.  The 
symptoms  of  the  two  stages  are  alike,  except  that  in 
the  second  there  is  a  swelling  of  the  gums  around  the 
tooth.  The  teeth  are  elongated  above  the  level  of  the 
surrounding  ones,  and  are  very  sore,  so  that  on  closing 
the  mouth  they  are  struck  first  and  a  painful  shock  is 
experienced.  They  are  also  discolored,  or  somewhat 
darker  than  the  surrounding  teeth;  a  bad  odor  also 
sometimes  issues  from  them. 

Treatment. — For  the  first  stage,  or  that  in  which 
there  is  mere  inflammation  of  the  lining  membrane  : 

1st.  Apply  a  dental  plaster  to  the  gums.  It  may 
be  obtained  at  almost  any  drug  store.     Or, 

2d.    Rub  iodine  and  aconite  in  equal  parts  around 


HINTS  ON  HOME  REMEDIES.  85 

the  gums  with  cotton,  or  a  camel's  hair  brush;  before 
the  mixture  is  appKed,  dry  the  gums  thoroughly.  The 
iodine  and  aconite  induce  a  healthy  flow  of  the  blood, 
and  facilitate  the  removal  of  the  waste  material.  Be 
careful  not  to  swallow  the  remedies,  as  they  are  poison- 
ous.    Or, 

3d.     Apply  a  leech  to  the  gums,  through  a  tube.  Or, 

4th.  Emplo}^  a  cathartic ;  it  will  reduce  the  quantity 
of  water  in  the  blood,  and  by  limiting  the  blood 
pressure  afford  relief. 

Treatment. — For  the  second  stage,  or  that  in  which 
the  inflammation  has  developed  an  abscess : 

1st.  Apply  warm  poultices  of  capsicum,  or  flaxseed, 
or  raisins. 

Capsicum  Poultice. — Place  in  a  small  cotton  bag  a 
mixture  consisting  of  three  parts  of  flour  and  one 
of  red-pepper  or  capsicum.  Warm  this  and  apply  it 
over  the  head  of  the  abscess  within  the  mouth.  It 
should  be  changed  every  three  hours. 

Flaxseed  Poultices. — These  may  be  made  by  wrap- 
ping flaxseed  in  strips  of  linen,  two  by  three  inches ; 
after  heating  them,  apply  them  around  the  abscessed 
gum ;  as  soon  as  the  poultice  becomes  cool,  remove  it 
and  substitute  a  warm  one.  The  abscess  is  thus  brought 
to  a  head  and  prepared  for  the  lance  of  the  dentist. 
Patients  should  never  attempt  to  do  their  own  lancing, 
lest  they  induce  blood  poisoning. 


86  CARE  OF  THE  TEETH  AND  MOUTH. 

Raisin  Poultice. — This  may  be  made  by  cutting  a 
number  of  large  raisins  into  halves,  taking  out  the 
seeds  and  heating  them.  One  of  these  should  be 
applied  to  the  gums,  directly  above  the  abscess.  As  soon 
as  it  becomes  cool,  change  it  for  a  warm  one.  Con- 
tinue this  treatment  for  several  hours. 

As  the  breath  is  feverish  and  foul  during  the  develop- 
ment of  an  abscess,  the  patient  should  use  either  of  the 
following  mouth-washes  several  times  a  day : 

1st.  Rinse  the  mouth  with  a  solution  made  from  a 
teaspoonful  of  bicarbonate  of  soda  in  a  glass  of  warm 
water. 

2d.  Or,  Listerine,  either  pure  or  diluted  with 
from  three  to  five  parts  of  water. 

3d.  Or,  the  following :  Carbolic  acid,  two  drams ; 
glycerine,  four  drams  ;  rose  water,  ten  ounces. 

Sometimes  the  abscess  is  so  large  that  the  cheek  is 
swollen.  In  such  cases  apply  cold  applications  to  the 
face,  in  addition  to  the  warm  applications  to  the  gums. 
N^ever  apply  heat  externally,  lest  the  abscess  burst 
there  and  leave  behind  it  an  ugly  scar. 

II.     Teeth  that  Ache  After  Being  Filled. 

Diagnosis. — Sometimes  a  tooth  is  prematurely  filled 
by  the  dentist ;  that  is  to  say,  he  fills  the  tooth  before 
he  has  thoroughly  quieted  the  nerve,  in  a  case  in  which 
the  pulp  is  living ;  or  in  one  in  which  the  pulp  is  dead, 


HINTS  ON  HOME  REMEDIES.  87 

he  fills  the  tooth  before  he  has  thoroughly  disinfected 
the  pulp  chamber  and  removed  the  dead  pulp.  It  may 
also  happen  that  after  the  cavity  has  been  filled,  in 
spite  of  all  precautions,  the  pulp  dies  beneath  the 
filling ;  hence  arise  two  classes  of  these  diseased  teeth 
— those  with  living  pulps,  and  those  with  dead  pulps. 

When  the  pulp  is  alive  beneath  the  tilling,  the  patient 
may  suffer  from  jumping,  or  intermittent  toothache. 

Treatment. — Any  one  of  the  following  measures  may 
be  employed  : 

1st.  Take  a  hot  foot  bath ;  this  will  equalize  the 
circulation,  and  by  relieving  the  blood  pressure  will 
relieve  the  pain. 

2d.  Take  a  saline  cathartic,  like  magnesia  or  epsom 
salts ;  this  will  diminish  the  quantity  of  water  in  the 
blood,  and  so  will  relieve  the  blood  pressure  on  the 
pulp. 

B.      "WHEN   THE   PULP   IS  DEAD  BENEATH    THE   FILLING. 

Diagnosis. — The  same  as  in  the  case  of  unfilled  teeth 
with  dead  pulps. 

Treatment. —  Also  the  same.  (See  disease  I,  sub- 
division B.) 

III.     Aching  Gums. 

This  may  be  due  to  an  accumulation  of  tartar  under- 
neath them,  to  colds,  to  laceration  due  to  extraction,  or 


50  CARE  OF  THE  TEETH  AND  MOUTH. 

to  the  irritation  produced  by  a  recent  cleaning  of  the 
teeth. 

A.      ACCUMULATION    OF   TAKTAK. 

Diagnosis. — The  gums  have  receded  from  the  necks 
of  the  teeth,  the  teeth  are  loose,  the  breath  is  foul,  and 
pus  oozes  from  the  gums. 

Treatment. — Kinse  the  mouth  with  tepid  water,  in 
which  one  or  two  teaspoonfuls  of  bicarbonate  of  soda 
have  been  dissolved.  Use  the  solution  at  intervals  of 
an  hour. 

B.       COLDS. 

Diagnosis. — The  pain  results  from  the  inflammation 
caused  by  exposure  to  currents  of  air  below  the  normal 
temperature  of  the  body. 

Treatment. — Paint  or  rub  the  gums  with  a  mixture 
of  equal  parts  of  aconite  and  iodine,  or  rinse  the  mouth 
with  a  solution  of  one  dram  of  borax,  or  chlorate  of 
potash,  in  a  glass  of  water. 

C.       PAINFUL    sensation    FROM   RECENT    CLEANING. 

Diagnosis. — After  the  teeth  have  been  cleaned  by 
the  dentist,  they  ache  for  a  day  or  two,  and  are  some- 
what sensitive. 

Treatment. — Rinse  the  mouth  with  either  of  the 
following  mouth-washes  : 

1st.  Dissolve  a  teaspoonful  of  common  salt  in  a 
glass  of  warm  water ;  to  be  used  every  half  hour. 


HINTS  ON  HOME  REMEDIES.  89 

2d.     Einse  the  mouth  ^yith  Listerine,  either  in  full 
strength  or  diluted  with  water. 


D.       LACERATED   GUMS    AFTER    EXTRACTION. 

Diagnosis. — After  the  teeth  have  been  extracted,  if 
the  gums  are  lacerated  and  torn  the  patient  will  suffer 
considerable  pain.  The  breath  may  also  be  foul, 
because  of  consequent  sloughing. 

Treatment. — Use  tincture  of  calendula,  dilute  it 
with  an  equal  quantity  of  water,  as  a  mouth-wash 
ever}'-  three  hours.  It  hardens  the  gums,  soothes  the 
pain,  and  sweetens  the  breath. 

IV.     Hemorrhage. 

Diagnosis. — It  sometimes  happens  that  the  extrac- 
tion of  a  tooth  is  followed  by  excessive  hemorrhage  or 
bleeding,  due  to  a  lack  of  coagulation  or  thickening 
property  in  the  blood,  or  to  a  hereditary  tendency  to 
hemorrhage. 

There  are  two  stages  of  hemorrhage — the  primary 
and  the  secondary.  The  primar}^  occurs  at  the  extrac- 
tion of  a  tooth,  and  is  normal ;  the  second  hemorrhage 
may  occur  several  hours,  or  even  a  da}^  or  two  after 
the  teeth  have  been  extracted. 

Treatment. — Place  the  patient  in  a  reclining  posi- 
tion, with  his  head  higher  than  the  rest  of  his  body,  and 


90  CAKE  OF  THE  TEETH  AND  MOUTH. 

apply  bags  of  hot  water  to  his  feet.  His  position  will 
prevent  a  determination  to  the  head,  and  the  water 
bags  will  draw  the  blood  to  the  lower  extremities. 

Before  applying  any  remedy  to  the  cavity,  wash  it 
very  carefully  with  warm  water,  or  the  remedy  will  not 
prove  as  effective. 

Make  a  firm  plug  of  styptic  cotton  and  force  it  into 
the  cavity ;  cut  a  notch  in  a  cork  of  suitable  size,  so 
that  it  may  sit  astride  the  gum ;  then  close  the  mouth 
firmly  upon  it,  and  bandage.  By  this  means  the  cotton 
will  be  forced  far  into  the  cavity,  and  thus  check  the 
flow  of  blood. 

Hold  in  the  mouth,  until  bleeding  has  stopped, 
a  portion  of  a  solution  of  two  drams  of  borax  in  a 
glass  of  warm  water. 

The  bleeding  cavity  may  also  be  plugged  with  leather 
scrapings,  alum,  cob-webs,  or  pieces  of  sponge  satur- 
ated in  nut-galls.  Any  one  of  these  will  usually  suflBce 
to  check  the  hemorrhage. 

While  these  remedies  are  being  employed,  the 
physician  or  dentist  should  be  sent  for  without  delay. 

Y.      J^EUEALGIA. 

Diagnosis. — Neuralgia  is  usually  due  to  a  bad  con- 
dition of  the  teeth,  but  it  may  arise  from  some  general 
disease,  for  the  teeth  may  be  perfectly  sound  and  yet 
the  patient  suffer  from  intense  neuralgia. 


HINTS  ON  HOME  REMEDIES.  91 

Here  let  me  say  that  I  shall  dismiss  the  neuralgias 
due  to  constitutional  conditions  from  consideration, 
as  their  treatment  lies  within  the  province  of  the 
physician. 

The  nerves  of  the  face  are  very  numerous  and 
closely  connected.  They  form  a  complex  net  work, 
which  is  instantly  aroused  if  any  of  the  filaments  are 
irritated. 

In  the  sensitiveness  and  rapidity  of  their  transmis- 
sions, nerves  are  like  electric  wires ;  an  aching  tooth 
may  thus  cause  intense  neuralgia,  by  inducing  sympa- 
thetic pain  among  the  nerves  of  the  face  and  the  head. 
Such  pain,  of  course,  can  only  be  assuaged  by  allaying 
the  pain  in  the  tooth.  Hence,  to  check  neuralgia  due 
to  any  of  the  teeth,  the  patient  need  only  ascertain 
what  particular  ailment — as  cold,  tartar,  recent  extrac- 
tion, a  dead  or  a  living  pulp — causes  the  pain,  and 
apply  the  proper  remedy. 

YI.     Foul  Breath. 

This  is  one  of  the  most  offensive  and  annoying 
features  accompanying  decayed  or  filthy  teeth.  It 
makes  its  victim  a  nuisance  in  society,  as  he  becomes 
absolutely  repulsive,  and  yet  it  is  rarely  referred  to, 
from  mistaken  notions  of  delicacy.  As  a  rule,  the 
patient  is  quite  unaware  of  his  condition.  Sometimes 
it  arises  from  a  disordered  stomach,  catarrhal  troubles, 


92  CAKE  OF  THE  TEETH  AND  MOUTH. 

or  some  general  disease.  If  this  be  the  case,  the  care 
lies  with  the  physician,  but  if  it  arises  from  bad  or 
filthy  teeth,  he  should  see  the  dentist,  and  in  the  mean- 
time take  internally  a  half  teaspoonful  of  Listerine 
after  each  meal,  at  the  same  time  rinsing  the  mouth  two 
or  three  times  a  day  with  tepid  water,  in  which  two 
or  three  grains  of  permanganate  of  potash  have  been 
dissolved. 

YII.     Artificial  Teeth. 

Diagnosis. — Before  becoming  accustomed  to  artificial 
teeth,  the  wearer  generally  suffers  from  soreness  of  the 
palate.  It  may  be  due  to  the  fact  that  the  plate  is  not 
accurately  fitted,  or  that  the  gums  have  not  suf- 
ficiently healed,  but  more  often  it  may  be  attributed  to 
the  novelty  of  having  an  artificial  contrivance  in  the 
mouth. 

Treatment. — Remove  the  teeth  for  a  few  days,  to 
allow  the  mouth  to  resume  its  normal  condition.  If 
there  is  considerable  soreness,  use  the  following  wash  : 

Take  a  lump  of  alum,  the  size  of  a  black- walnut,  and 
place  it  in  a  half  glass  of  water.  Keep  it  there  for  five 
minutes ;  then  rinse  the  mouth  with  the  solution. 

"With  a  camels-hair  brush  paint  the  sore  places  of  the 
mouth,  or  the  corresponding  positions  on  the  plate, 
with  the  following : 

Into  a  two-ounce  bottle,  with  a  wide  mouth,  put  an 


HINTS  ON  HOME  REMEDIES.  93 

ounce  of  glycerine,  place  it  in  a  hot  bath,  and  stir  in 
slowly  two  ounces  of  tannic  acid. 

This  will  also  be  found  an  excellent  remedy  for  the  lips 
when  chapped  or  made  sore  by  dental  operations. 

If  these  do  not  afford  relief,  see  the  dentist.  Here 
let  me  say  that  much  unnecessary  suffering  is  the 
result  of  persistently  removing  the  plate  and  allowing 
it  to  remain  out  of  the  mouth  for  a  greater  or  less 
period  of  time,  while  the  patient  is  becoming  habituated 
to  it.  In  spite  of  some  pain  and  inconvenience  he 
should  persevere,  and  only '  when  the  intensity  of  his 
suffering  becomes  unbearable  should  the  plate  be  re- 
moved, and  the  treatment  above  outlined  be  employed, 

YIII.     Dislocated  Jaws. 

Diagnosis. — Sometimes  during  laughing,  vomiting, 
etc.,  the  lower  jaw  is  dislocated ;  that  is  to  say,  the 
joints  or  condyles  are  forced  out  of  the  sockets.  "When 
this  is  the  case  it  will  be  found  impossible  to  close  the 
mouth,  or  to  move  the  lower  jaw. 

Treatment. — I.  Let  the  patient  sit  in  a  low  chair  that 
is  tilted  backward  so  that  the  head  rests  firmly  against 
the  wall.  Next  let  some  friend  wrap  his  thumbs  in  a 
napkin,  or  some  other  material  that  will  protect  them 
against  being  bitten,  and  grasping  the  sufferer's  chin, 
so  that  the  thumbs  rest  upon  the  upper  surface  of 
the  lower  back  teeth,   while  the   remaining    fingers 


94 


CARE  OF  THE  TEETH  AND  MOUTH. 


encircle  the  outside  of  the  chin,  let  him  exert  a  quick 

downward  and  back- 
ward pressure,  and  the 
jaw  will  be  forced  into 
place. 

II.  Take  a  stick  of 
convenient  size  and 
about  a  foot  long,  and 
apply  one  end  of  it  to 
the  upper  surface  of 
the  lower  back  teeth  on 
one  side ;  raise  the  free 
end  of  it  upward,  thus 
using  it  as  a  lever,  and 
exerting  great  down- 
ward and  backward 
pressure,  when  the  jaw 
will  be  sprung  into 
place     on      that     side. 

Do  precisely  the  same  thing  on  the  other  side,  and  this 

will  also  assume  its  proper  position. 

IX.     Gas  Extkaotion. 

Diagnosis. — Sometimes  after  gas  has  been  adminis- 
tered, a  strong  feeling  of  drowsiness  seizes  the  patient. 

Treatment. — Let  him  get  into  the  fresh  air,  and  in- 
hale large  draughts  of  it,  also  taking  a  little  brandy  to 


A  dislocated  jaw. 


HINTS  ON  HOME  REMEDIES.  95 

Stimulate  the  action  of  the  heart.  If  the  desire  for 
sleep  be  not  gratified,  the  drowsiness  will  soon  pass 
away. 

X.  When  the  gums  are  lacerated  after  extraction, 
it  is  sometimes  impossible  to  eat  solid  food.  Make  a 
mixture  consisting  of  a  glass  of  boiled  milk,  two  soft 
boiled  eggs,  and  some  sugar;  drink  this  and  it  will 
prove  as  nourishing  as  a  good  sized  steak. 

In  conclusion,  let  me  say  that  these  remedies  are 
but  make-shifts ;  they  may  afford  temporary  relief  from 
pain,  but  they  do  not  remove  the  cause  of  it.  This 
remains,  and  with  every  recurrence  of  the  pain 
the  efficacy  of  the  remedies  becomes  less  and  less,  until 
finally  it  is  reduced  to  nothing.  Hence  there  can  be 
but  one  source  of  permanent  relief,  and  that  is  to  strike 
at  the  root  of  the  trouble ;  thus,  if  you  suffer  from  the 
accumulation  of  tartar,  let  the  dentist  remove  it;  if 
you  suffer  from  aching  filled  teeth,  have  him  either 
extract  them,  or  take  out  the  fillings  and  prepare  them 
again  for  fresh  filling. 

Let  the  patient  remember,  too,  that  it  is  not  sufficient 
to  have  only  the  aching  teeth  attended  to ;  wherever  it 
is  necessary,  let  them  be  clean,  filled  or  capped,  for 
thus  only  can  every  source  of  disease  be  removed  and 
the  mouth  be  restored  to  a  healthy  condition. 


CHAPTEE  XII. 

QUACKEKT. 

Evert  family  has  its  black  sheep,  all  professions 
their  quacks,  and  dentistry  is  no  exception  to  the  gen- 
eral rule.  Here,  much  more  easily  than  in  any  other 
profession,  deceit  and  ignorance  may  be  palmed  off 
upon  the  layman  for  a  considerable  length  of  time, 
with  little  fear  of  detection  or  exposure.  You  are  all 
familiar  with  his  quackship,  who  may  be  recognized  by 
his  gaudy  signs  and  alluring  advertisements.  Here  are 
some  of  them : 

"  Teeth  cleaned  for  50  cents ! " 

"  Teeth  filled  for  50  cents  ! " 

"Teeth  extracted  with  pain  for  25  cents;  without 
pain  for  50  cents !  " 

"  Artificial  teeth  made  for  $5.00  while  you  wait !  " 

Enticing  signs,  these,  are  they  not  ? 

"  Teeth  cleaned  for  50  cents !  " 

How  can  a  reputable  dentist  clean  a  set  of  teeth  for 
this  sum?  How  can  any  professional  man  live  as  befits 
his  station,  and  meet  the  current  expenses  of  his  office, 
and  work  for  50  cents  an  hour  ?    'No  dentist,  however 


QUACKERY.  97 

skilled  and  ingenious  he  may  be,  can  on  an  average 
thoroughly  clean  a  set  of  teeth  in  less  than  an  hour, 
and  how  often,  when  the  mouth  is  very  filthy,  must  he 
work  even  two  and  three  hours.  It  requires  this 
length  of  time  to  clean  a  set  of  teeth,  because,  as  I  have 
shown  in  a  preceding  chapter,  cleaning  the  teeth  does 
not  consist  in  merely  giving  to  exposed  surfaces  a 
bright  polish,  but  in  thoroughly  removing  the  tartar 
from  beneath  the  gums,  where  it  has  accumulated  in 
thick,  incrusting  cakes. 

How  then,  you  will  ask,  can  the  quack  clean  the 
teeth  for  50  cents?  How?  Through  the  use  of  de- 
structive agents.  By  the  application  of  a  powerful  acid 
he  can  do  the  work  of  hours  in  a  few  moments.  But 
for  the  reasons  that  I  have  already  explained,  in  those 
few  minutes  the  action  of  the  acid  has  wroug-ht 
greater  destruction  than  many  years  of  wear  and  tear 
could  effect.  This  is  how  the  quack  works,  and  that  is 
why  he  can  work  cheaply. 

"  Teeth  filled  for  fifty  cents !  " 

How  can  any  reputable  dentist  afford  to  fill  a  tooth 
for  that  sum  ?  How  ?  Listen  to  the  experience  of  Mr. 
A.,  which  is  that  of  hundreds  of  others : 

"  I  had  my  teeth  filled  by  the  dentist,  and  the  pain 
was  intensified  a  thousand  fold.  I  suffered  from  jump- 
ing toothache,  and  from  abscesses,  until  I  was  almost 
driven  wild.     It  was  not  until  the  filling:  fell  out  of  the 


98  CAEE  OF  THE  TEETH  AND  MOUTH. 

tooth  (thanks  to  bad  workmanship)  that  I  obtained 
any  rehef  from  the  severity  of  my  sufferings."  Upon 
carefully  questioning  the  indignant  complainant,  it 
leaked  out  that  he  had  been  enticed  into  the  parlors  of 
the  60-cent  dentist. 

Good  filling  requires  that  the  dentist  should  carefully 
examine  the  tooth  before  he  undertakes  to  fill  it,  so 
that  he  may  discover  whether  it  is  alive  or  dead.  If  it 
is  living,  before  he  can  fill  it  the  pulp  must  be  soothed ; 
and  if  it  is  dead,  the  pulp-chamber  and  canals  must  be 
thoroughly  cleaned  and  disinfected. 

This  preliminary  work  is  laborious  and  difficult,  and 
no  dentist  can  undertake  it  for  the  mere  pittance  my 
complaining  friend  so  generously  paid.  If  he  suffered 
from  jumping  toothache,  it  was  because  the  dentist 
worked  the  filling  into  the  tooth  before  the  inflamed 
pulp  was  quieted,  and  so  aggravated  its  irritated  con- 
dition. If  he  suffered  from  abscesses  and  swellings,  it 
was  because  his  tooth  was  filled  before  the  pulp- 
chamber  and  canals  were  properly  disinfected.  If  the 
filling'fell  out  shortly  after  it  was  put  in,  it  was  because 
the  dentist  had  not  spent  a  sufficient  and  necessary 
length  of  time  in  shaping  the  cavity  for  its  retention. 

"  Teeth  extracted  with  pain  for  25  cents ;  without 
pain  for  50  cents  !  " 

The  quack  excels  in  one  department  of  dentistry — 
extraction.     He  takes  out  everything  that  comes  in  his 


QUACKERY. 


99 


way.  Extraction  is  a  joy  to  his  heart.  He  glories 
and  revels  in  it.  Never  by  any  chance  does  he  advise 
his  patient  to  have  a  tooth  filled,  capped,  or  crowned, 
or  to  employ  any  one  of  the  numerous  excellent  con- 
trivances which  modern  dentistry  has  invented.  He 
always  urges  that  it  be  pulled.  The  task  of  extraction 
is  brief,  and  the  remuneration  comparatively  high, 
when  one  considers  that  he  charges  the  same  price  for 
the  more  difficult  work  of  fllhng  or  cleaning. 

The  harm  thus  worked  by  the  quack  is  incalculable. 
Many  a  tooth  thus  ruthlessly  removed  might  have  been 
saved  by  the  reputable  dentist.  The  majority  of 
decaying  teeth  are  not  so  far  gone  but  that  the  skill- 
ful practitioner  can,  by  some  one  of  the  many  ingenious 
means  in  vogue,  manage  to  preserve  them. 

"Artificial  teeth  made  for  |5.00  while  you  wait!" 

How  absurd.  No  one,  be  he  ever  so  clever,  can  make 
a  set  of  teeth  in  less  than  a  day  or  two,  nor  can 
any  dentist,  without  sacrificing  the  welfare  of  his 
patient,  afford  to  make  teeth  at  such  ridiculously  low 
figures. 

Two  elements  enter  into  determining  the  value  of  a 
set  of  artificial  teeth — workmanship  and  material. 

Workmanship. — This  includes  :  1st,  natural  appear- 
ance; 2d,  accurate  fit;  3d,  such  adaptation  as  will 
enable  tlie  possessor  to  perform  mastication  and  articu- 
lation. 


100  CAKE  OF  THE  TEETH  AND  MOUTH. 

Natural  Appearance. — The  teeth  must  be  so  con- 
structed as  to  preserve  all  the  characteristics  of  the 
natural  organs,  and  conform  to  the  physiognomy  of  the 
patient.  Shall  they  be  large  and  powerful,  small  and 
dainty,  or  shall  they  be  of  medium  size  ?  "What  hue  and 
shade  shall'  be  selected  ?  These  are  questions  that  the 
dentist  can  only  answer  after  careful  study  of  each 
individual  case,  for  the  patient  can  readily  perceive  that 
a  set  of  teeth  may  be  of  very  fine  material,  and  yet 
may  mar  his  appearance,  because  they  are  not  in 
harmony  with  his  general  facial  expression. 

Accuracy  of  Fit. — Perfect  adaptability  of  the  denture 
to  the  tissues  is  necessary,  in  order  that  it  may  set 
firmly  in  the  mouth.  This  adaptability  can  only  be 
obtained  at  a  great  expenditure  of  time,  which  the 
quack  cannot  afford,  since  he  must  compensate  his 
cheapness  of  price  by  rapidity  of  work. 

Dental  plates  are  manufactured  on  models  made 
from  impressions  of  the  mouth.  These  impressions 
may  be  taken  in  wax,  or  some  similar  compound,  or  in 
plaster  of  paris.  The  former  are  taken  easily,  but  they  are 
inaccurate.  The  latter  are  obtained  with  difficulty, 
but  they  are  exact.  It  is  needless  to  say  that  our 
friends  of  the  flourishing  advertisements  always  dabble 
with  wax  and  similar  materials. 

Mastication  and  Articulation. — I  need  hardly  tell 
the  reader  that  unless  the  teeth  are  well  constructed, 


QUACKERY.  101 

mastication  and  articulation  can  only  be  performed 
with  great  difficulty  and  inconvenience. 

Material. — Many  people  labor  under  the  impression 
that  artificial  teeth  are  all  of  the  same  grade  of 
material.  This  view  is  erroneous.  Just  as  our  clothing 
may  be  of  inferior  or  superior  quality,  so  it  is  with 
the  porcelain  from  which  artificial  teeth  are  manu- 
factured. 

There  are  two  classes  of  porcelain  teeth.  One  pos- 
sesses such  a  remarkably  vital  appearance,  that  when 
put  alongside  of  the  natural  teeth  the  most  critical  eye 
will  often  fail  to  distinguish  between  them.  This  close 
imitation  results  from  study,  and  refined,  artistic  taste. 

The  other  class  has  a  dull,  opaque  and  lifeless  appear- 
ance. It  lacks  all  those  essential  characteristic 
features  which  make  the  former  kind  of  porcelain  in- 
valuable in  dental  art. 

The  reason,  therefore,  why  the  quack  works  at  such 
low  figures  is,  that  he  employs  poor  workmanship  and 
poor  material.  The  better  class  of  porcelain  is  worth 
fully  three  times  as  much  as  the  inferior  kind,  and  as 
to  the  relative  values  of  good  and  bad  workmanship, 
there  can  be  no  comparison  whatever.  The  quack 
works  minutes,  while  the  painstaking  dentist  works 
hours. 

Poor  teeth  are  injurious  physicall}^  jesthetically  and 
financially. 


102         CAKE  OF  THE  TEETH  AND  MOUTH. 

Physically,  because  they  are  a  source  of  discomfort 
to  the  patient.  JEsthetically,  because  they  mar  his 
appearance,  and  financially,  because  they  are  not 
durable. 

Teeth  are  necessities,  not  luxuries.  Bad  is  the  policy, 
and  worse  the  intelligence  that  will,  for  the  sake  of 
apparently  saving  a  few  dollars,  buy  ugly  trash  instead 
of  valuable  and  durable  material.  The  few  dollars'  dif- 
ference in  the  price  between  good  and  bad  teeth  are,  I 
said,  only  seemingly  saved.  This  is  true,  because  the 
poorer  class  of  teeth  are  worthless  in  every  respect, 
whether  as  masticators,  articulators,  or  beautifiers,  and 
they  must  soon  be  discarded  for  something  better. 

As  usual,  the  greatest  sufferers  at  the  hands  of  the 
quack  are  the  poorer  people,  who  are  readily  attracted 
by  the  cheap  prices  and  the  golden  promises  of  speedy 
benefits.  For  them  we  may  have  sympathy.  There 
is,  however,  a  class  of  people  who  have  the  means 
wherewith  to  pay  for  good  dental  work,  and  whom 
experience  should  have  taught  that  whatever  is  abnor- 
mally cheap  is  worthless.  For  them  there  is  no  excuse. 
If  they  have  been  deceived,  they  have  only  obtained 
their  just  deserts.  Poverty  may  be  offered  as  an 
extenuation,  but  for  greed  there  is  no  excuse. 

In  the  long  run  it  will  pay  rich  and  poor  alike  to 
select  a  dentist,  not  from  the  standpoint  of  cheapness, 
but  of  ability.     It  is  true  that  he  may  charge  what 


QUACKERY. 


103 


appears  to  be  large  prices,  but  the  patient  will  have  the 
satisfaction  of  knowing  that  he  has  had  faithful  work, 
and  that  he  has  been  given  the  benefit  of  the  best 
fruits  of  great  industry  and  knowledge. 

As  a  matter  of  fact,  however,  not  even  the  poor  man 
has  any  reason  for  resorting  to  the  quack,  for  every 
good  dentist  is  imbued  with  such  a  love  for  his  profes- 
sion that  he  considers  not  alone  the  financial  side,  but 
is  always  ready  to  make  due  allowance  for  those  who 
cannot  afford  to  pay  him  his  regular  fees.  Nothing 
then,  save  a  false  sentijnent  of  pride  which  may  make 
him  ashamed  to  ask  for  the  reduction,  need  drive  the 
poor  patient  from  the  doors  of  the  skilled  practitioner 
to  the  quack. 

I  have  sought,  in  this  chapter,  to  point  out  the  delu- 
sion of  cheap  prices,  and  the  danger  and  menace  that 
the  quack  is  to  society.  If  I  have  succeeded,  I  shall 
have  rendered  an  important  service  to  every  one  who  is 
obliged  to  seek  the  services  of  the  dentist. 


RX61  B41 

Bell 

Popular  essays  upon  the  care  of 


the  teeth. 


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